Which of the following statements regarding single- and dual-chamber pacing is true? A 57-year-old male patient returns for a regular follow-up visit. He recently had a dual chamber pacemaker implanted to treat symptomatic sinus node dysfunction. He asks why a dual-chamber pacemaker was needed.
A. Dual-chamber pacing is associated with a decreased incidence of heart failure admissions and of atrial fibrillation, as compared with single-chamber pacing B. Excessive pacing of the right ventricle by dual-chamber pacemakers decreases hospitalizations for heart failure C. Pacemaker syndrome is not commonly associated with single-chamber ventricular pacemakers D. Single-chamber atrial pacemakers are recommended to treat atrioventricular dysfunction
Dual-chamber pacing is associated with a decreased incidence of heart failure admissions and of atrial fibrillation, as compared with single-chamber pacing-in patients with sinus rhythm in whom a substantial amount of pacing is anticipated, single-chamber ventricular pacemakers should be avoided, for three reasons: they may cause so-called pacemaker syndrome (i.e., symptoms related to av dyssynchrony during ventricular pacing); they are associated with a higher likelihood of developing atrial fibrillation; and recent evidence indicates that excessive right ventricular pacing should be avoided if possible. single-chamber atrial pacemakers can be used in patients with sinus node dysfunction and normal av conduction. however, single-chamber atrial pacemakers are not widely used in the united states because of the possibility, often unpredictable, of the development of problems with av conduction, resulting either from progression of conduction system disease or from necessary drug therapy. dual-chamber pacing prevents pacemaker syndrome by preserving atrioventricular synchrony. compared with single-chamber ventricular pacing, dual-chamber pacing has been shown to decrease the incidence of atrial fibrillation and heart failure hospitalization, especially in patients with sinus node dysfunction. however, excessive amounts of right ventricular pacing from dual-chamber pacemakers are associated with increased likelihood of atrial fibrillation and heart failure hospitalization.