Subjective and Objective Response to Single‐ Versus Dual‐Chamber Pacing

With two different questionnaires, we analyzed the feeling of well‐being during dual chamber pacing mode and VVI mode in 25 randomly selected patients, mean age 66.7 years (range 22–84). All patients had high degree AV block and received either a DDD pacemaker (23 patients) or a VDD pacemaker. Under each pacing mode exercise tests were performed as well. Questionnaire 1 was answered during DDD or VDD mode. According to questionnaire 1, 76% of the patients remembered their symptoms before PM implantation. Eighty‐two percent of the patients felt an improvement of their symptoms after the installation of the pacemaker. Questionnaire 2 was answered after a three‐week period of VVI pacing. Fifty‐six of the patients indicated a deterioration of their general conditions, 36% of the patients noted dizziness, 58% dyspnea, 40% reduced effort tolerance, and 22% a sleep disturbance. After a change to dual‐chamber pacing, general well‐being was better in 74% of the patients, dyspnea was noted in only 15%, effort tolerance was improved in 61%, and sleep was undisturbed in 97%. The physical work capacity (expressed as a product of Watts multiplied by minutes) tested on a bicycle ergometer was 400 ± 190 Wmin in VVI mode and 414 ± 272 Wmin in DDD/VDD mode (p = ns). The double products were 14,600 ± 4,934 and 22,066 ± 5,585 (p < 0.05), respectively. We conclude that dual‐chamber pacing leads to a significant improvement in the quality of life for patients with symptomatic AV block.