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Effect of pacing mode on patients with sick sinus syndrome

CHEN Ke-ping,TANG Min,CHEN Ruo-han,HUA Wei,PU Jie-lin,ZHANG Shu,CHEN Xin.Center of Arrhythmia Diagnosis and Treatment,Fuwai Hospital,CAMS and PUMC,Beijing 100037,China  
Objective A randomized trial was done to compare single-chamber atrial(AAI)and dual-chamber(DDD)pacing in patients with sick sinus syndrome(SSS).Methods Patients with SSS who were implanted with DDD pacemakers from August 2001 to February 2004 were enrolled.They were randomized to AAI pacing or DDD pacing.The primary end point was development of atrial fibrillation.The second end points were quality of life(QOL),changes in left atrial and left ventricular size,as well as cardiac function measured by M-mode echocardiography.Analysis was made on an intention-to treat basis.Results A total of 111 consecutive patients were enrolled. Thirty-eight patients were programmed to AAI pacing and 73 patients were programmed to DDD pacing.Mean follow-up was(22.23±10.98) months.Atrial fibrillation was significantly less common in the AAI group than in DDD group(23.68% vs 50.68%,P0.01).Left atrial and left ventricular size and cardiac function were not statistically changed before pacemaker implantation and at each follow-up.There was no difference in these values between AAI and DDD group.QOL was improved after pacemaker implantation in both groups,but there was no statistical difference between AAI and DDD group.Conclusion Atrial fibrillation is significantly less common in AAI group than in DDD group.
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