Assessment of BNP Level in Patients with Single Chamber and Dual Chamber Pacemakers

Background: Recent years, have witnessed extended and continuous indication of cardiac pacing. However,
increasing number of patients suffered new congestive heart failure (CHF) and aggravated CHF after pacing
therapy. We used blood B type nutriuretic peptide (BNP) to predict the occurrence of CHF in patients with different
types of pacemakers. To assess single N-terminal brain nutriuretic peptide (NT-pro BNP) as a predictor
tool for ventricular dysfunction in different cardiac pacing mode.
Methods: Out of 480 consecutive patients with pacemaker more than 6 months, 79 patients with average age
of 65±13, and more than 90% ventricular pacing participated in the present study. Those with CHF prior to
pacemaker insertion were excluded. The patients underwent medical history and examination, echocardiography
(M-mode, Doppler, and Tissue imaging) and blood sampling for pro-BNP. Twenty five, 12, and 42 patients
had Dual chamber (DDDR), single chamber pacing with dual chamber sensing ( VDDR), and Single chamber
(VVIR) pacemakers respectively
Results: Single pro-BNP level in patient with DDDR and VDDR pacing was lower than in those with VVIR
pacing (P< 0.0001) but in Echocardiography left ventricular (LV) dysfunction was not lower in DDDR than
VDDR and VVIR pacing patients (P= 0.190).
Conclusion: Single level of pro-BNP is lower in double chamber pacing in comparison with single chamber
pacing. Therefore, it seems that dual chamber pacing causes less LV dysfunction.