Ventricular pacemaker upgrade: experience, complications and recommendations

Objective To assess outcomes of pacemaker upgrade from single chamber ventricular to dual chamber. Design—Retrospective analysis of patients undergoing the procedure. Setting—Specialist cardiothoracic unit. Patients—44 patients (15 female, 29 male), mean (SD) age at upgrade 68.2 (12.9) years. Interventions—Upgrade of single chamber ventricular to dual chamber pacemaker. Main outcome measures Procedure duration and complications. Results—Principal indications for upgrade were pacemaker syndrome (17), “opportunistic”—that is, at elective generator replacement (8), heart failure (7), non-specific breathlessness/fatigue (7), and neurally mediated syncope (3). Mean (SD) upgrade procedure duration (82.9 (32.6) minutes) significantly exceeded mean VVI implantation duration (42.9 (13.3) minutes) and mean DDD implantation duration (56.6 (22.7) minutes) (both p