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Europace. 2014 Nov;16(11):1595-602. doi: 10.1093/europace/euu055. Epub 2014 Apr 4.

Reduction of unnecessary right ventricular pacing by managed ventricular pacing and search AV+ algorithms in pacemaker patients: 12-month follow-up results of a randomized study.

Author information

1
Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangzhou, China.
2
Clinical EP Lab and Arrhythmic Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishilu, Beijing 100037, China.
3
Department of Cardiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang, China.
4
Department of Cardiology, Zhejiang Hospital, Zhejiang, China.
5
Department of Cardiology, First Peoples' Hospital of Yunnan Province, Yunnan, China.
6
Department of Cardiovascular, The Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang, China.
7
Medtronic (Shanghai) Management Co., Ltd., Shanghai, China.
8
Medtronic, Inc., MN, USA.
9
Clinical EP Lab and Arrhythmic Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishilu, Beijing 100037, China zsfuwai@vip.163.com.

Abstract

AIMS:

The present study was to assess the reduction of right ventricular pacing (RVP) by pacemaker algorithms of Managed Ventricular Pacing (MVP) and Search AV+ (SAV+) interval over a period of 12 months.

METHODS AND RESULTS:

A total of 385 patients indicated for a dual-chamber pacemaker (DC-PM) were enrolled in the prospective, randomized COMPARE study at 29 centres in China between June 2009 and April 2011. Patients implanted with DC-PMs were randomized in a 1 : 1 ratio to the MVP group or the SAV+ group. The percentage of VP (%VP) was obtained from the device diagnostic data at 1-, 6-, and 12-month follow-ups and was expressed as the median %VP over all beats in patients with sinus node dysfunction (SND) and atrioventricular block (AVB) excluding persistent third-degree AVB. Of 385 enrolled patients, 253 had SND and 72 had AVB. The %VP in the MVP group was significantly lower than that in the SAV+ group at 1-, 6-, and 12-month follow-ups, respectively. At 12-month follow-up, the median %VP in SND patients was 0.20% in the MVP group and 1.4% in the SAV+ group (P < 0.0001) and the median %VP in AVB patients was 11.8% in the MVP group and 98.1% in the SAV+ group (P < 0.001). There was no statistical difference in %VP from 1- to 12-month follow-up. A trend in the correlation between %VP and AT/AF burden was observed.

CONCLUSION:

Over 12-month follow-up, the %VP was lower for MVP than SAV+ in patients with either SND or AVB. The sustainable %VP reduction has potential implications in reducing the development of heart failure and/or atrial arrhythmia morbidity.

KEYWORDS:

Atrioventricular block; Dual-chamber pacemaker; Managed ventricular pacing; Right ventricular pacing; Sinus node dysfunction

PMID:
24706091
DOI:
10.1093/europace/euu055
[Indexed for MEDLINE]
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