Reduction of Right Ventricular Pacing with Advanced Atrioventricular Search Hysteresis: Results of the PREVENT Study.
In: Pacing & Clinical Electrophysiology, Jg. 34 (2011-08-01), Heft 8, S. 975-983
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Zugriff:
Background: Right ventricular pacing predisposes to the development of heart failure and atrial fibrillation. Automatic atrioventricular search hysteresis (AVSH) is a commonly used strategy to decrease the percentage of right ventricular pacing (%VP) in patients without permanent AV block, but the results have not been optimal. Methods: The randomized, crossover PREVENT study evaluated whether an enhanced AVSH with two new features can reduce %VP compared with standard AVSH. The new features are the repetitive hysteresis [switch from extended to basic AV delay after a consistent loss of intrinsic AV conduction (IAVC) lasting for six consecutive atrial cycles] and the scan hysteresis (periodic IAVC search extension over six consecutive atrial cycles). Both standard AVSH and enhanced AVSH performed a periodic IAVC search every 180 cardiac cycles and operated with a basic AV-delay of 225 ms and a rate-independent maximum AV-delay of 300 ms for paced and sensed atrial events. Results: Among 178 patients, 53.4% had no evidence of AV block at enrollment and 46.6% had history of intermittent AV block. The median %VP was decreased by enhanced AVSH compared to standard AVSH (4.0% vs 5.5%, P < 0.001), particularly in patients with a history of AV block (21.4% vs 25.5%, P < 0.001). The primary study hypothesis that 25% of all patients would experience > 20% relative %VP reduction was not met as 46 (25.8%) patients (95% confidence interval, 20.5-31.8%) presented such relative reduction. Conclusion: The enhanced AVSH algorithm reduces %VP compared with standard AVSH in patients with intermittent AV block. (PACE 2011; 34:975-983) [ABSTRACT FROM AUTHOR]
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Reduction of Right Ventricular Pacing with Advanced Atrioventricular Search Hysteresis: Results of the PREVENT Study.
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Autor/in / Beteiligte Person: | KOLB, CHRISTOF ; SCHMIDT, ROLAND ; DIETL, JOSEF U. ; WEYERBROCK, SONJA ; MORGENSTERN, MARTIN ; FLECKENSTEIN, MARTIN ; BEIER, THOMAS ; VON BARY, CHRISTIAN ; MACKES, KARL G. ; WIDMAIER, JOCHEN ; KREUZER, JÖRG ; SEMMLER, VERENA ; ZRENNER, BERNHARD |
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Zeitschrift: | Pacing & Clinical Electrophysiology, Jg. 34 (2011-08-01), Heft 8, S. 975-983 |
Veröffentlichung: | 2011 |
Medientyp: | academicJournal |
ISSN: | 0147-8389 (print) |
DOI: | 10.1111/j.1540-8159.2011.03075.x |
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