Enkelkamerpacing

Enkelkamerpacing, or single-chamber pacing, is a cardiac pacing modality in which a pacemaker delivers electrical stimulation to a single heart chamber and senses activity in that same chamber. The two common configurations are ventricular single-chamber pacing (VVI or VVIR) and atrial single-chamber pacing (AAI or AAIR). A transvenous lead is placed in the right ventricle (for VVI) or the right atrium (for AAI), while the pacemaker generator sits in the chest. The device typically operates as a demand pacemaker, delivering impulses only when the intrinsic heart rate falls below a preset threshold; many devices also include rate-responsive features that adjust pacing rate to activity.

Advantages of enkelkamerpacing include a simpler system, smaller generator size, shorter implantation procedure, lower energy consumption, and potentially longer battery life due to the use of a single lead. This can be particularly advantageous in patients with limited venous access or higher infection risk. Disadvantages include the lack of atrioventricular (AV) synchrony when pacing the ventricle, which can reduce hemodynamic efficiency and lead to symptoms or pacemaker syndrome in some cases. Because AV coordination is not preserved, single-chamber pacing may be less suitable for patients who could benefit from AV synchrony and stable exercise capacity.

Indications typically include chronic bradyarrhythmias such as sick sinus syndrome or certain AV blocks where AV synchrony is not essential, persistent atrial fibrillation with a slow ventricular response, or situations where a dual-chamber system is not feasible due to anatomy, infection risk, or resource constraints. In modern practice, choice between single- and dual-chamber pacing depends on the patient’s rhythm, comorbidities, and goals of therapy, with single-chamber devices still used in select cases.