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. 2023 Dec 18;10(1):e23877.
doi: 10.1016/j.heliyon.2023.e23877. eCollection 2024 Jan 15.

Dual-chamber versus single chamber pacemakers, a systemic review and meta-analysis on sick sinus syndrome and atrioventricular block patients

Abdul Rehman Shah Syed  1 , Abdullah Akram  1 , Muhammad Shaheryar Azam  1 , Ayesha Irshad Ansari  1 , Muhammad Ali Muzammil  1 , Abdul Ahad Syed  1 , Shaheer Ahmed  1 , Syeda Javeria Zakir  1
Affiliations

Dual-chamber versus single chamber pacemakers, a systemic review and meta-analysis on sick sinus syndrome and atrioventricular block patients

Abdul Rehman Shah Syed et al. Heliyon. .

Abstract

Aims: The atrioventricular block (AVB) is a conduction system problem that results from the impairment in the transmission of an impulse from the atria to the ventricle, the disease has many etiologies. This article aimed to evaluate the efficacy and safety of dual and single-chamber pacemakers in patients with SSS and AVB.

Methods: An electronic search of PubMed (Medline), EMBASE, and Google Scholar was performed from 2000 till August 15th, 2022. Retrieved articles were exported to Endnote Reference Library Software, where duplicate studies were removed from the list, and only articles meeting the eligibility criteria of this study were selected. RevMan 5.4 and STATA 16 software were used for the analysis. The modified Cochrane Collaboration's risk of bias and New-castle Ottawa scale were used for quality assessment of RCTs and observational studies respectively.

Results: This study is composed of 8953 patients with sick-sinus syndrome and atrioventricular block. A total of thirteen outcomes are included in this meta-analysis, out of which atrial fibrillation significantly favored dual chamber [OR = 1.29; 95 % CI = 1.05-1.59; P = 0.01 I2 = 29 %] and overall complications [OR = 0.48; 95 % CI = 0.29-0.77; p = 0.03 I2 = 0 %] and pneumothorax [OR = 0.31; 95 % CI = 0.10-0.93; p = 0.04, I2 = 0 %] were satisfied by single-chamber pacing.

Conclusion: This study concluded that neither single-chamber nor dual-chamber pacemakers are superior to each other, but they are unique in their own ways as the results of this study manifest remarkable reduction in atrial fibrillation rates and pneumothorax using dual-chamber and single-chamber pacemakers respectively.

Keywords: Atrioventricular block; Heart failure care; Sick-sinus syndrome; atrial fibrillation; pacemaker.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Prisma flow chart.
Fig. 2
Fig. 2
Forest Plots of Outcome of Included Clinical Trials 2 A = Stroke, 2B= All-cause mortality, 2C= Heart failure, 2D = Hospitalization due to heart failure, 2E = Mortality due to cardiovascular disease, 2F= Atrial fibrillation.
Fig. 3
Fig. 3
Forest Plots of Outcomes of Included Observational Studies 3 A = Atrial fibrillation, 3B= Congestive heart failure, 3C= All-cause mortality, 3D = Overall complication, 3E = Pneumothorax, 3F= Atrial lead dislodgement.
See this image and copyright information in PMC

References

    1. Tracy C.M., Epstein A.E., Darbar D., DiMarco J.P., Dunbar S.B., Estes N.A., 3rd, Ferguson T.B., Jr., Hammill S.C., Karasik P.E., Link M.S., Marine J.E., Schoenfeld M.H., Shanker A.J., Silka M.J., Stevenson L.W., Stevenson W.G., Varosy P.D., Ellenbogen K.A., Freedman R.A., Gettes L.S., Gillinov A.M., Gregoratos G., Hayes D.L., Page R.L., Stevenson L.W., Sweeney M.O. American College of cardiology foundation; American heart association task force on practice guidelines; heart rhythm society. 2012 ACCF/AHA/HRS focused update of the 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: a report of the American College of cardiology foundation/American heart association task force on practice guidelines and the heart rhythm society. [corrected] Circulation. 2012 Oct 2;126(14):1784–1800. doi: 10.1161/CIR.0b013e3182618569. Epub 2012 Sep 10. Erratum in: Circulation. 2013 Jan 22;127(3):e357-1800. Heart Rhythm Society [added]. PMID: 22965336. - DOI - PubMed
    1. Walsh-Irwin C., Hannibal G.B. Sick sinus syndrome. AACN Adv. Crit. Care. 2015 Oct-Dec;26(4):376–380. doi: 10.1097/NCI.0000000000000099. PMID: 26485000. - DOI - PubMed
    1. Dobrzynski H., Boyett M.R., Anderson R.H. New insights into pacemaker activity: promoting understanding of sick sinus syndrome. Circulation. 2007 Apr 10;115(14):1921–1932. doi: 10.1161/CIRCULATIONAHA.106.616011. PMID: 17420362. - DOI - PubMed
    1. Jensen P.N., Gronroos N.N., Chen L.Y., Folsom A.R., deFilippi C., Heckbert S.R., Alonso A. Incidence of and risk factors for sick sinus syndrome in the general population. J. Am. Coll. Cardiol. 2014 Aug 12;64(6):531–538. doi: 10.1016/j.jacc.2014.03.056. PMID: 25104519; PMCID: PMC4139053. - DOI - PMC - PubMed
    1. Rodriguez R.D., Schocken D.D. Update on sick sinus syndrome, a cardiac disorder of aging. Geriatrics. 1990 Jan;45(1):26–30. 33-6. PMID: 2403955. - PubMed

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