INDICATIONS FOR USE AND SIDE EFFECTS

The use of the NEWAY DR pulse generator is indicated in all cases of sinus node disease or conduction defects which might benefit from atrioventricular synchronization to improve hæmodynamics.
The indications include (DDDR and DDD modes):


  • sinus node block on physical effort

  • sinus node disease with serious bradytachy syndrome

  • atrioventricular block with normal sinus function

  • permanent or paroxysmal sinus dysfunction associated or disassociated with atrioventricular conduction problems

  • vaso-vagal or hypersensitive syndrome of the carotid sinus

  • intolerance to VVI pacing (pacemaker syndrome) in presence of persistent sinus rhythm
  • bi-lateral branch block

In cases of atrial tachycardia, atrial fibrillation or flutter and premature atrial contraction (PAC), the system benefits from a check of ventricular stimulation rate thanks to the Physiological Mode Switching algorithm which is based on continual monitoring of heart rate variability (HRV).

In any case, the ability to analyse the diagnostic information stored in the pacer’s memory and therefore program various pacing modes satisfies most needs. In some cases of retrograde ventricular conduction, the use of atrial- triggered modes (DDD, VDD) can often activate the protection mechanism against pacemaker-mediated tachycardia. It is therefore advisable to evaluate carefully the most appropriate atrial refractory period or to select a non- synchronized pacing mode e.g. DDI, which is specifically indicated for bradytachy syndrome.

No important negative side effects of permanent pacing are known. Certain potential complications, such as loss of sensing, loss of pacing or over- sensing, can be overcome by reprogramming sensitivity, refractory periods or pulse amplitude respectively. Other possible complications arising from pacemaker implantation are: abnormal tissue reaction, infection, tissue necrosis, muscular stimulation, lead displacement, lead fracture or breakdown, electromagnetic or myopotential interference.