---
abstract: "After implantation of a permanent pacemaker, patients may experience severe symptoms of dyspnea, palpitations, malaise, and syncope resulting from pacemaker syndrome. Although pacemaker syndrome is most often ascribed to the loss of atrioventricular (A-V) synchrony, more recent data may also implicate left ventricular dysynchrony caused by right ventricular pacing. Previous studies have not shown reductions in mortality or stroke with rate-modulated dual-chamber (DDDR) pacing as compared to ventricular-based (VVI) pacing. The benefits in A-V sequential pacing with the DDDR mode are likely mitigated by the interventricular (V-V) dysynchrony imposed by the high percentage of ventricular pacing commonly seen in the DDDR mode. Programming DDDR pacemakers to encourage intrinsic A-V conduction and reduce right ventricular pacing will likely decrease heart failure and pacemaker syndrome. Studies are currently ongoing to address these questions.\n"
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- http://www.ipej.org/0404/link.htm
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creators_id: []
creators_name:
- family: Farmer
given: Michael D
honourific: ''
lineage: ''
- family: Estes
given: Mark NA III
honourific: ''
lineage: ''
- family: Link
given: Mark S
honourific: ''
lineage: ''
date: 2004-10
date_type: published
datestamp: 2005-04-14
department: ~
dir: disk0/00/00/41/84
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editors_id: []
editors_name:
- family: Singh
given: Balbir
honourific: ''
lineage: ''
- family: Lokhandwala
given: Yash
honourific: ''
lineage: ''
- family: Francis
given: Johnson
honourific: ''
lineage: ''
- family: Gupta
given: Anup
honourific: ''
lineage: ''
eprint_status: archive
eprintid: 4184
fileinfo: /style/images/fileicons/application_pdf.png;/4184/1/link.pdf|/style/images/fileicons/text_html.png;/4184/2/link.htm
full_text_status: public
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ispublished: pub
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item_issues_count: 0
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keywords: "VVI = ventricular-based, VVIR = rate modulated ventricular-based, A-V = atrioventricular, V-V = interventricular, V-A = ventricular-atrial, LBBB = left bundle branch block, LVEF = left ventricular ejection fraction, DDDR = rate modulated dual-chamber, SND = sinus node dysfunction, AAI = single-chamber atrial, AF = atrial fibrillation, LV = left ventricular, RV= right ventricular\n"
lastmod: 2011-03-11 08:55:54
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metadata_visibility: show
note: ~
number: 4
pagerange: 195-200
pubdom: TRUE
publication: Indian Pacing and Electrophysiology Journal
publisher: Indian Pacing and Electrophysiology Group
refereed: TRUE
referencetext: |-
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16. Rosenqvist M, Isaaz K, Botvinivk EH, et al. Relative importance of activation sequence compared to atrioventricular synchrony in left ventricular function. Am J Cardiol. 1991;67:148-156.
17. Mark JB, Chetman PM. Ventricular pacing can induce hemodynamically significant mitral valve regurgitation. Anesthesiology. 1991;74:375-377.
18. Lamas GA, Ellenbogen KA. Evidence Base for Pacemaker Mode Selection: From Physiology to Randomized Trials. Circulation 2004;109:443-451.
19. Kerr CR, Connolly SJ, Abdullah HM, Roberts RS, et al. Canadian Trial of Physiological Pacing during long term follow-up. Circulation. 2004; 109(3):357-62.
20. Sweeney MO, Hellkamp AS, Ellenbogen KA, et al. Adverse effect of ventricular pacing on heart failure and atrial fibrillation among patients with normal baseline QRS duration in a clinical trial of pacemaker therapy for sinus node dysfunction. Circulation. 2003;107:2932-2937.
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reportno: ~
rev_number: 14
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status_changed: 2007-09-12 16:56:32
subjects:
- ipej
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title: "New Concepts in Pacemaker Syndrome\n"
type: journalp
userid: 4424
volume: 4