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Reduction of right ventricular pacing with advanced atrioventricular search hysteresis: results of the PREVENT study.
- Source :
-
Pacing and clinical electrophysiology : PACE [Pacing Clin Electrophysiol] 2011 Aug; Vol. 34 (8), pp. 975-83. Date of Electronic Publication: 2011 Mar 25. - Publication Year :
- 2011
-
Abstract
- 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.<br />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.<br />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.<br />Conclusion: The enhanced AVSH algorithm reduces %VP compared with standard AVSH in patients with intermittent AV block.<br /> (©2011, The Authors. Journal compilation ©2011 Wiley Periodicals, Inc.)
Details
- Language :
- English
- ISSN :
- 1540-8159
- Volume :
- 34
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Pacing and clinical electrophysiology : PACE
- Publication Type :
- Academic Journal
- Accession number :
- 21438891
- Full Text :
- https://doi.org/10.1111/j.1540-8159.2011.03075.x