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Unlabelled: As pacing impedance is inversely related to pacing current, the increase of pacing impedance additionally decreases pacing current. Whether the impedance measurement at implantation predicts the outcome during follow-up, was studied in 87 patients who received the VDD-single lead UniPass 425 connected to the pacemaker Unity (Sulzer Intermedics). The impedance changes between implantation and 6 months follow-up were assessed for each patient. Similar impedance values were defined, if the two measurements were within a range < or = -100 to +100 omega. Six-months impedance was lower or higher compared to implantation, if the difference exceeded > -100 or > +100 omega. At implantation, impedance was 535 +/- 98 omega (range: 333-811 omega) and significantly increased to 604 +/- 160 omega (range: 361-1150 omega) after 6 months. Mean difference between the two measurements was 69 +/- 162 omega (range: -336 bis + 560 omega). Similar impedance had 43 (implantation: 527 +/- 75 omega, 6 months: 531 +/- 87 omega), lower values 11 (implantation: 660 +/- 83 omega, 6 months: 494 +/- 73 omega) and higher values 33 patients (implantation: 503 +/- 99 omega, 6 months: 735 +/- 168 omega). Compared to the patients with similar impedance patients with lower impedance had a significantly higher impedance values at implantation., Conclusions: Pacing impedance increased significantly within 6 months after implantation. Pacing impedance changed > 100 omega in 51% of the patients. The long-term follow-up of pacing impedance can be predicted generally, but not for the individual patient.

Background and Objective: Implantation of a VDD pacemaker (ventricular pacing; dual sensing [atrial and ventricular]; dual response [triggered + inhibited]) together with a single VDD electrode catheter restores synchronous AV ventricular stimulation in patients with higher-grade AV block and intact sinus function. If higher-frequency stimulation occurs it may be a sign of pacemaker malfunction or of inadequate pacemaker programming. This study was undertaken to determine, at first follow-up examination, in how many patients with a VDD pacemaker VVI stimulation occurred more than 5% of the time; how such patients differed from those with 5% or fewer VVI stimulations; and whether a changed program reduced the proportion of VVI stimulations., Patients and Methods: 67 consecutive patients were tested 1 to 3 months after implantation of the Unity VDD pacemaker (Sulzer Intermedics). The frequency of VVI stimulations was determined via a diagnostic pacemaker memory store. After intermediate analysis, programming was optimized and the patients then re-tested 12 months after the initial implantation., Results: At the first follow-up examination 54 patients had VVI stimulations of < or = 5% (0.5 +/- 0.9%) and 13 had > 5% of the time (19.8 +/- 10.7%). The two groups differed significantly from one another in their lower intervention frequency (< or = 5% VVI stimulations: 47 +/- 6/min; > 5% VVI stimulations: 58 +/- 5/min). In particular, the pacemakers in patients with > 5% VVI stimulations had been significantly more often programmed to values of > 50/min. As a result, the pacemakers of these patients were reprogrammed to a lower frequency. A year after implantation there was no longer any difference in the lower intervention frequency, 44 +/- 4/min, between patients with initially > 5% VVI stimulations and those with initially < or = 5% stimulations. At the same time, the proportion of VVI stimulations fell to 4 +/- 6%, with 67% of patients having AV synchronicity of > 95%., Interpretation: At first follow-up, patients with > 5% VVI stimulations differed from those with < or = 5% stimulations with regard to an increased lower intervention frequency. In most of these patients the proportion of AV stimulations was increased to > 95% by reducing the lower intervention frequency to < or = 50/min.