1990 Volume 19 Issue 3 Pages 1011-1015
Four hundred and thirty two patients, treated with implantable pacemaker, were divided into two groups according to pacing modes (non-physiologic and physiologic pacing), Non-physiologic pacing (VVI)had not only some demerits oar patient's daily life and/or low cardiac output caused by disregard of atrial contribution such as pacemaker syndrome, but also showed significant decrease of survival rate in SSS group through whole observation period. The most important difference between two pacing groups was incidence of thromboembolic episodes, which was clearly higher in non-physiologic pacing than in physiologic pacing on SSS group.
Reason of favorable effect of physiologic pacing on avoiding thromboembolic episodes was presumably its AV synchrony, which might dissolve thrombogenetic factors in left atrium such as intraatrial hemostasis or conversion from regular atrial contraction to atrial fibrillation, For some cases, on which DDD pacemaker could not increase heart rate on exercise because of severe sinus node dysfunction, combination of rate responsive mechanism and DDD type pacemaker (DDD) should be the most suitable pacing mode.
