{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T03:48:17Z","timestamp":1788407297532,"version":"build-2803163510"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T00:00:00Z","timestamp":1747353600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T00:00:00Z","timestamp":1747353600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100008375","name":"University of Basel","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100008375","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Interv Card Electrophysiol"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Single chamber atrial pacing (AAI) provides a disease-specific treatment for sick sinus syndrome (SSS) but has largely been replaced by DDD pacing. With the advent of leadless atrial pacemakers (PM), there is growing interest in long-term follow-up data in patients with SSS and an AAI pacemaker.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Purpose<\/jats:title>\n            <jats:p>To assess the incidence of system upgrade in patients treated with AAI-PM for SSS during long-term follow-up.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>This is an analysis of prospectively enrolled patients undergoing implantation of an AAI-PM. Wenckebach block point (WBP) was measured at implantation and serially during follow up.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>We included 178 patients (58% female, median age at implantation 77 [71\u201383] years). The median follow-up duration was 6.5 [2.0\u20139.7] years. Twenty-three patients (13%) received a system upgrade to a DDD system, corresponding to a yearly upgrade rate of 2.0%. Median time to system upgrade was 5.2 [1.6\u20138.7] years. Reasons for system upgrade were higher-degree AVB (39%), atrial arrhythmias (35%), low WBP (17%), and syncope (9%). Median WBP at implantation was 130 [120\u2013140] bpm, showing a significant decline over time in the upgrade-group compared to the rest of the cohort with 103 [91\u2013130] bpm vs. 130 [120\u2013130] bpm (<jats:italic>p<\/jats:italic>\u2009=\u20090.011).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>In this cohort of patients undergoing AAI-PM implantation for SSS, upgrade to a DDD system was low during long-term follow-up. Therefore, AAI pacing for the treatment of SSS may be considered a patient-tailored treatment option, especially in light of novel leadless pacing therapies.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Graphical abstract<\/jats:title>\n            <jats:p>Central Illustration: AF = atrial fibrillation; AT = atrial tachycardia; AVB = atrioventricular block; WBP = Wenckebach block point; AAI = single-chamber atrial stimulation<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s10840-025-02061-4","type":"journal-article","created":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T12:15:28Z","timestamp":1747397728000},"page":"1605-1612","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Long-term follow up of single-chamber atrial pacing\u2014system upgrade and Wenckebach block point behavior: potential implications for leadless AAI pacing?"],"prefix":"10.1007","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9751-0557","authenticated-orcid":false,"given":"Patrick","family":"Badertscher","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Arnet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corinne","family":"Isenegger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Behnam","family":"Subin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sven","family":"Knecht","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Trussardi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Krisai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Mahfoud","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Sticherling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beat","family":"Sch\u00e4r","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"K\u00fchne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,5,16]]},"reference":[{"issue":"4","key":"2061_CR1","doi-asserted-by":"publisher","first-page":"614","DOI":"10.1016\/S0735-1097(03)00757-5","volume":"42","author":"JC Nielsen","year":"2003","unstructured":"Nielsen JC, Kristensen L, Andersen HR, Mortensen PT, Pedersen OL, Pedersen AK. A randomized comparison ofatrial and dual-chamber pacing in177 consecutive patients with sick sinus syndrome. J Am Coll Cardiol. 2003;42(4):614\u201323. https:\/\/doi.org\/10.1016\/S0735-1097(03)00757-5.","journal-title":"J Am Coll Cardiol"},{"issue":"23","key":"2061_CR2","doi-asserted-by":"publisher","first-page":"2932","DOI":"10.1161\/01.CIR.0000072769.17295.B1","volume":"107","author":"MO Sweeney","year":"2003","unstructured":"Sweeney MO, Hellkamp AS, Ellenbogen KA, et al. Adverse effect of ventricular pacing on heart failure and atrial fibrillation among patients with normal baseline QRS duration in a clinical trial of pacemaker therapy for sinus node dysfunction. Circulation. 2003;107(23):2932\u20137. https:\/\/doi.org\/10.1161\/01.CIR.0000072769.17295.B1.","journal-title":"Circulation"},{"issue":"10","key":"2061_CR3","doi-asserted-by":"publisher","first-page":"1000","DOI":"10.1056\/NEJMoa071880","volume":"357","author":"MO Sweeney","year":"2007","unstructured":"Sweeney MO, Bank AJ, Nash N, et al. Minimizing ventricular pacing to reduce atrial fibrillation in sinus-node disease. N Engl J Med. 2007;357(10):1000\u20138. https:\/\/doi.org\/10.1056\/NEJMoa071880.","journal-title":"N Engl J Med"},{"issue":"9","key":"2061_CR4","doi-asserted-by":"publisher","first-page":"764","DOI":"10.1016\/j.jacc.2009.06.006","volume":"54","author":"LF Tops","year":"2009","unstructured":"Tops LF, Schalij MJ, Bax JJ. The effects of right ventricular apical pacing on ventricular function and dyssynchrony. J Am Coll Cardiol. 2009;54(9):764\u201376. https:\/\/doi.org\/10.1016\/j.jacc.2009.06.006.","journal-title":"J Am Coll Cardiol"},{"issue":"13","key":"2061_CR5","doi-asserted-by":"publisher","first-page":"1315","DOI":"10.1161\/01.CIR.98.13.1315","volume":"98","author":"HR Andersen","year":"1998","unstructured":"Andersen HR, Nielsen JC, Thomsen PEB, et al. Atrioventricular conduction during long-term follow-up of patients with sick sinus syndrome. Circulation. 1998;98(13):1315\u201321. https:\/\/doi.org\/10.1161\/01.CIR.98.13.1315.","journal-title":"Circulation"},{"issue":"12","key":"2061_CR6","doi-asserted-by":"publisher","first-page":"1267","DOI":"10.1016\/S0300-8932(02)76799-7","volume":"55","author":"JL Mor\u00ed\u00f1igo","year":"2002","unstructured":"Mor\u00ed\u00f1igo JL, Arribas A, Ledesma C, S\u00e1nchez PL, Mart\u00edn F, Mart\u00edn LC. Clinical safety and efficacy of single-chamber atrial pacing in sick sinus syndrome: long-term follow-up. Rev Esp Cardiol. 2002;55(12):1267\u201372.","journal-title":"Rev Esp Cardiol"},{"issue":"3","key":"2061_CR7","doi-asserted-by":"publisher","first-page":"358","DOI":"10.1046\/j.1460-9592.2001.00358.x","volume":"24","author":"L Kristensen","year":"2001","unstructured":"Kristensen L, Nielsen JC, Pedersen AK, Mortensen PT, Andersen HR. AV block and changes in pacing mode during long-term follow-up of 399 consecutive patients with sick sinus syndrome treated with an AAI\/AAIR pacemaker. Pacing Clin Electrophysiol. 2001;24(3):358\u201365. https:\/\/doi.org\/10.1046\/j.1460-9592.2001.00358.x.","journal-title":"Pacing Clin Electrophysiol"},{"issue":"5","key":"2061_CR8","doi-asserted-by":"publisher","first-page":"444","DOI":"10.1016\/j.eupc.2004.05.003","volume":"6","author":"H Masumoto","year":"2004","unstructured":"Masumoto H, Ueda Y, Kato R, et al. Long-term clinical performance of AAI pacing in patients with sick sinus syndrome: a comparison with dual-chamber pacing. EP Europace. 2004;6(5):444\u201350. https:\/\/doi.org\/10.1016\/j.eupc.2004.05.003.","journal-title":"EP Europace"},{"issue":"4","key":"2061_CR9","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1111\/j.1540-8159.2005.08672.x","volume":"28","author":"IG Tripp","year":"2005","unstructured":"Tripp IG, Armstrong GP, Stewart JT, Hood MA, Smith WM. Atrial pacing should be used more frequently in sinus node disease. Pacing Clin Electrophysiol. 2005;28(4):291\u20134. https:\/\/doi.org\/10.1111\/j.1540-8159.2005.08672.x.","journal-title":"Pacing Clin Electrophysiol"},{"issue":"6","key":"2061_CR10","doi-asserted-by":"publisher","first-page":"832","DOI":"10.3349\/ymj.2010.51.6.832","volume":"51","author":"WH Kim","year":"2010","unstructured":"Kim WH, Joung B, Shim J, et al. Long-term outcome of single-chamber atrial pacing compared with dual-chamber pacing in patients with sinus-node dysfunction and intact atrioventricular node conduction. Yonsei Med J. 2010;51(6):832\u20137. https:\/\/doi.org\/10.3349\/ymj.2010.51.6.832.","journal-title":"Yonsei Med J"},{"issue":"4","key":"2061_CR11","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1136\/hrt.80.4.387","volume":"80","author":"K Clarke","year":"1998","unstructured":"Clarke K, Connelly D, Charles R. Single chamber atrial pacing: an underused and cost-effective pacing modality in sinus node disease. Heart. 1998;80(4):387\u20139.","journal-title":"Heart"},{"issue":"4","key":"2061_CR12","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1136\/hrt.80.4.315","volume":"80","author":"HJ Marshall","year":"1998","unstructured":"Marshall HJ, Gammage MD, Griffith MJ. AAI pacing for sick sinus syndrome: first choice on all counts. Heart. 1998;80(4):315\u20136. https:\/\/doi.org\/10.1136\/hrt.80.4.315.","journal-title":"Heart"},{"issue":"12","key":"2061_CR13","doi-asserted-by":"publisher","first-page":"1185","DOI":"10.1093\/europace\/eum231","volume":"9","author":"M K\u00fchne","year":"2007","unstructured":"K\u00fchne M, Schaer B, Kaufmann C, et al. A randomized trial comparing two different approaches of pacemaker selection. EP Europace. 2007;9(12):1185\u201390. https:\/\/doi.org\/10.1093\/europace\/eum231.","journal-title":"EP Europace"},{"issue":"35","key":"2061_CR14","doi-asserted-by":"publisher","first-page":"3427","DOI":"10.1093\/eurheartj\/ehab364","volume":"42","author":"M Glikson","year":"2021","unstructured":"Glikson M, Nielsen JC, Kronborg MB, et al. 2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy: developed by the task force on cardiac pacing and cardiac resynchronization therapy of the European Society of Cardiology (ESC) With the special contribution of the European Heart Rhythm Association (EHRA). Eur Heart J. 2021;42(35):3427\u2013520. https:\/\/doi.org\/10.1093\/eurheartj\/ehab364.","journal-title":"Eur Heart J"},{"issue":"6","key":"2061_CR15","doi-asserted-by":"publisher","first-page":"686","DOI":"10.1093\/eurheartj\/ehr022","volume":"32","author":"JC Nielsen","year":"2011","unstructured":"Nielsen JC, Thomsen PEB, H\u00f8jberg S, et al. A comparison of single-lead atrial pacing with dual-chamber pacing in sick sinus syndrome. Eur Heart J. 2011;32(6):686\u201396. https:\/\/doi.org\/10.1093\/eurheartj\/ehr022.","journal-title":"Eur Heart J"},{"key":"2061_CR16","unstructured":"Schweizerische Stiftung f\u00fcr Rhythmologie. Accessed 23 Feb 2024. https:\/\/www.rhythmologie-stiftung.ch\/statistiken_de.html"},{"issue":"1","key":"2061_CR17","doi-asserted-by":"publisher","first-page":"7","DOI":"10.5603\/KP.a2014.0148","volume":"73","author":"M Kuniewicz","year":"2015","unstructured":"Kuniewicz M, Rydlewska A, Karkowski G, Lelakowska-Pie\u0142a M, Majewski J, Lelakowski J. Effectiveness of atrial versus atrioventricular pacing for sick sinus syndrome during long-term follow-up. Pol Heart J (Kardiologia Polska). 2015;73(1):7\u201316. https:\/\/doi.org\/10.5603\/KP.a2014.0148.","journal-title":"Pol Heart J (Kardiologia Polska)"},{"issue":"12","key":"2061_CR18","doi-asserted-by":"publisher","first-page":"1981","DOI":"10.1093\/europace\/euw364","volume":"19","author":"NH Brandt","year":"2017","unstructured":"Brandt NH, Kirkfeldt RE, Nielsen JC, et al. Single lead atrial vs. dual chamber pacing in sick sinus syndrome: extended register-based follow-up in the DANPACE trial. EP Europace. 2017;19(12):1981\u20137. https:\/\/doi.org\/10.1093\/europace\/euw364.","journal-title":"EP Europace"},{"issue":"1","key":"2061_CR19","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1016\/j.ihj.2023.12.004","volume":"76","author":"R Velayuthan","year":"2024","unstructured":"Velayuthan R, Sukumar SK, Bootla D, et al. Pacing mode survival in patients with single chamber atrial pacemaker for sinus node dysfunction. Indian Heart J. 2024;76(1):27\u201330. https:\/\/doi.org\/10.1016\/j.ihj.2023.12.004.","journal-title":"Indian Heart J"},{"issue":"25","key":"2061_CR20","doi-asserted-by":"publisher","first-page":"2360","DOI":"10.1056\/NEJMoa2300080","volume":"388","author":"RE Knops","year":"2023","unstructured":"Knops RE, Reddy VY, Ip JE, et al. A dual-chamber leadless pacemaker. N Engl J Med. 2023;388(25):2360\u201370. https:\/\/doi.org\/10.1056\/NEJMoa2300080.","journal-title":"N Engl J Med"},{"issue":"Supplement_4","key":"2061_CR21","doi-asserted-by":"publisher","first-page":"iv3","DOI":"10.1093\/europace\/euab042","volume":"23","author":"HC Han","year":"2021","unstructured":"Han HC, Hawkins NM, Pearman CM, Birnie DH, Krahn AD. Epidemiology of cardiac implantable electronic device infections: incidence and risk factors. EP Europace. 2021;23(Supplement_4):iv3\u201310. https:\/\/doi.org\/10.1093\/europace\/euab042.","journal-title":"EP Europace"},{"issue":"10","key":"2061_CR22","doi-asserted-by":"publisher","first-page":"1187","DOI":"10.1001\/jamacardio.2021.2621","volume":"6","author":"JP Piccini","year":"2021","unstructured":"Piccini JP, El-Chami M, Wherry K, et al. Contemporaneous comparison of outcomes among patients implanted with a leadless vs transvenous single-chamber ventricular pacemaker. JAMA Cardiol. 2021;6(10):1187\u201395. https:\/\/doi.org\/10.1001\/jamacardio.2021.2621.","journal-title":"JAMA Cardiol"},{"issue":"9","key":"2061_CR23","doi-asserted-by":"publisher","first-page":"euad269","DOI":"10.1093\/europace\/euad269","volume":"25","author":"MAD Alhuarrat","year":"2023","unstructured":"Alhuarrat MAD, Kharawala A, Renjithlal S, et al. Comparison of in-hospital outcomes and complications of leadless pacemaker and traditional transvenous pacemaker implantation. EP Europace. 2023;25(9):euad269. https:\/\/doi.org\/10.1093\/europace\/euad269.","journal-title":"EP Europace"}],"container-title":["Journal of Interventional Cardiac Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10840-025-02061-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10840-025-02061-4\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10840-025-02061-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,27]],"date-time":"2025-09-27T06:58:38Z","timestamp":1758956318000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10840-025-02061-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,16]]},"references-count":23,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,11]]}},"alternative-id":["2061"],"URL":"https:\/\/doi.org\/10.1007\/s10840-025-02061-4","relation":{},"ISSN":["1572-8595"],"issn-type":[{"value":"1572-8595","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,16]]},"assertion":[{"value":"26 February 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 April 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 May 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Patrick Badertscher has received research funding from the \u201cUniversity of Basel \u201c, the \u201cSwiss Heart Foundation\u201d, the Foundation for Cardiovascular Research Basel and Johnson&Johnson, and reports personal fees from Bayer, BMS\/Pfizer, Boston Scientific and Abbott, all outside the submitted work.Philipp Krisai reports speaker fees from BMS\/Pfizer. Grants from the Swiss National Science Foundation, Swiss Heart Foundation, Foundation for Cardiovascular Research Basel, Machaon Foundation.Felix Mahfoud is supported by Deutsche Gesellschaft f\u00fcr Kardiologie (DGK), Deutsche Forschungsgemeinschaft (SFB TRR219, Project-ID 322900939), and Deutsche Herzstiftung. Until May 2024, FM has received speaker honoraria\/consulting fees from Ablative Solutions, Amgen, Astra-Zeneca, Bayer, Boehringer Ingelheim, Inari, Medtronic, Merck, ReCor Medical, Servier, and Terumo all outside the submitted work.Christian Sticherling, member of Medtronic Advisory Board Europe and Boston Scientitic Advisory Board Europe, received educational grants from Biosense Webster and Biotronik and a research grant from the European Union\u2019s FP7 program and Biosense Webster and lecture and consulting fees from Abbott, Medtronic, Biosense-Webster, Boston Scientific, Microport, and Biotronik all outside the submitted work.Beat Sch\u00e4r reports speaker fees from Medtronic.Michael K\u00fchne reports grants from the Swiss National Science Foundation (Grant numbers 33 CS30_148474, 33 CS30_177520, 32473B_176178 and 32003B_197524), the Swiss Heart Foundation, the Foundation for Cardiovascular Research Basel, and the University of Basel, grants from Bayer, grants from BMS, grants from Boston Scientific, grants from Daiichi Sankyo, grants from Pfizer, personal fees from Abbott, personal fees from Boston Scientific, personal fees from Daiichi Sankyo, Royalties from Springer (ECG book), all outside the submitted work.The remaining authors have nothing to declare.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}