What is a DDD Pacemaker?

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  • Written By: Mary McMahon
  • Edited By: Kristen Osborne
  • Last Modified Date: 25 November 2019
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A DDD pacemaker is a mechanical pacemaker placed in both the atria and ventricles, with sensors to monitor the heart's rhythm in both locations. It acts on demand, triggering a heartbeat when the heart does not do so spontaneously. This type of pacemaker is widely used for permanent pacemaking, and the programming can be adjusted to meet the needs of the patient, depending on the specific condition a patient has and the reason the pacemaker is being implanted.

In pacemaker classification, each letter provides information about the functions of the pacemaker. The first letter tells the user which chamber of the heart is paced by the device. A indicates the atria, V is for the ventricles, and D symbolizes both chambers. The second letter provides information about which chambers are sensed by the pacemaker, with the same letter codes along with 0, meaning no sensing function is available. The third letter indicates what the device does in response to the sensations it receives. It may be 0, reflecting the lack of sensing, I for inhibit to show that the pulse from the pacemaker can be suppressed, T for trigger to indicate that a pulse will be triggered, and D, indicating that the pacemaker can trigger and inhibit.


The DDD pacemaker acts on demand, taking action appropriate to what is happening inside the patient's heart at any given time. The internal clock on the device can be programmed to meet the patient's needs, and most devices also have sensors designed to help the pacemaker adjust to the patient's level of activity. When people are working hard and need a higher heart rate, the pacer can speed up, ramping back down as the they cool down and resumes more sedentary activities.

Before the pacemaker is implanted, it is checked to confirm it is working properly. After installation, it is programmed and tested. It will regulate the patient's heartbeat, addressing health problems caused by an abnormal rhythm. Pacemakers can be reprogrammed externally, as well as being checked for errors if a patient reports problems like irregular heart rate or discomfort in the chest. Diagnostics may reveal the need for reprogramming or a new pacemaker.

Understanding the letter designations on a pacemaker can be helpful for a patient who wants to understand what the device does. The DDD variety provides a highly flexible set of modes, but may not necessarily be needed in all patients.


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Post 4

@salmonriver: At the end of the person's life, the pacemaker keeps firing or pacing until the battery runs out. The person cannot be taken to the morgue until the pacer stops firing. There are ways to deactivate the pacer.

Post 3

My grandmother has a St. Jude Pacemaker. I think hers is a DDD pacemaker. I didn’t know pacemakers adjusted to the person’s level of activity. That is pretty cool. I think it’s interesting how they have leads that attach to the heart. I am always impressed with the technology used to improve and keep up our health.

I am not very familiar with the different companies that make pacemakers. My grandma and her physician decided that the St. Jude’s was the best device for her. I have seen pictures of the pacemaker on the website.

It’s interesting to think that is inside her. I thought it was really cool hers has daily wireless monitoring that provides information about the pacemaker and if follow ups are needed.

Post 2

I have spent time working in health care. While I worked with elderly patients, hospice care had a prevalent role. We also found it fairly common to work with patients in that age group who had pacemakers for heart problems.

As for hospice, or end of life, cares, there was some debate among my coworkers as to the role of a pacemaker. The general thought seemed to be that a patient with a pacemaker who was at the end of life tended to hang on longer because the mechanism would not allow their heart to stop.

I haven’t talked to a doctor about this, but some of the nurses I worked with thought this played a part. I still the think the pacemaker is very worth it, but it makes me wonder what happens when a patient with a pacemaker reaches the end of their time.

Post 1

When a person has pacemaker surgery they can expect to stay in the hospital for at least one night -- that's what my grandpa did.

Mild pain and swelling in the area where the pacemaker was placed is normal for about a week after surgery. Over-the-counter medicine will usually relieve it.

Most doctors recommend that you avoid heavy lifting for about a month but you can return to normal activities a few days after surgery.

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