ISSN: 0300-8932 Factor de impacto 2023 7,2
Vol. 7. Núm. G.
Páginas 69G-81G (Octubre 2007)

Estimulación cardiaca con marcapasos
Selección del modo de estimulación en las bradiarritmias. Controversias sobre la indicación del modo AAI o el modo DDD en la enfermedad del nódulo sinusal y sobre la utilización del modo VDD en el bloqueo auriculoventricular

Pacing Mode Selection for Bradyarrhythmias. Controversies Concerning Indications for the AAI Mode Versus the DDD Mode in Sick Sinus Syndrome and on the Use of the VDD Mode for Atrioventricular Block

Claudio Ledesma Garcíaa¿Ramón García CalabozobAgustín Pastor Fuentesc

Opciones

Desde que en los años cincuenta se introdujo la estimulación cardiaca como tratamiento de las bradiarritmias cardiacas, el marcapasos cardiaco implantable ha sufrido una progresiva sofisticación y un continuo intento de aproximación, en su funcionamiento, a la fisiología normal del corazón. Al mismo tiempo, las indicaciones para implantación de un marcapasos han ido variando durante los últimos años y se han consensuado por expertos en documentos (Guías de Actuación Clínica) basados en la experiencia y en el índice de evidencia existente para cada indicación. A pesar de ello, siguen evidenciándose discrepancias entre estas indicaciones claramente establecidas y el modo de estimulación utilizado para el tratamiento de las bradiarritmias sintomáticas. Probablemente, los dos modos que ofrecen más discrepancia en su utilización sean los modos AAI y VDD. En este capítulo se realiza una revisión de las indicaciones de estimulación cardiaca, resaltando las nuevas evidencias existentes en cuanto al modo de estimulación, lugar de estimulación y efectos indeseables de la estimulación cardiaca. Asimismo, se analiza la controversia existente sobre la estimulación AAI y la estimulación DDD en la enfermedad del nódulo sinusal y la utilización del modo VDD en el bloqueo auriculoventricular.

Palabras clave

Bradiarritmias
Estimulación con marcapasos
Selección del modo de estimulación
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