J 2014

Managed ventricular pacing compared with conventional dual-chamber pacing for elective replacement in chronically paced patients: Results of the Prefer for Elective Replacement Managed Ventricular Pacing randomized study

BOTTO, Giovanni L., Renato P. RICCI, Juan M. BENEZET, Jens Cosedis NIELSEN, Luc DE ROY et. al.

Základní údaje

Originální název

Managed ventricular pacing compared with conventional dual-chamber pacing for elective replacement in chronically paced patients: Results of the Prefer for Elective Replacement Managed Ventricular Pacing randomized study

Autoři

BOTTO, Giovanni L. (380 Itálie), Renato P. RICCI (380 Itálie), Juan M. BENEZET (724 Španělsko), Jens Cosedis NIELSEN (208 Dánsko), Luc DE ROY (56 Belgie), Olivier PIOT (250 Francie), Aurelio QUESADA (724 Španělsko), Raffaele QUAGLIONE (380 Itálie), Diego VACCARI (380 Itálie), Claudio GARUTTI (528 Nizozemské království), Lidwien VAINER (528 Nizozemské království) a Milan KOZÁK (203 Česká republika, garant, domácí)

Vydání

Heart Rhythm, New York, Elsevier Science, 2014, 1547-5271

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30201 Cardiac and Cardiovascular systems

Stát vydavatele

Spojené státy

Utajení

není předmětem státního či obchodního tajemství

Impakt faktor

Impact factor: 5.076

Kód RIV

RIV/00216224:14110/14:00079796

Organizační jednotka

Lékařská fakulta

UT WoS

000336395600013

Klíčová slova anglicky

Cardiac pacing; Managed ventricular pacing; Dual-chamber pacing; Randomized controlled trial; Outcomes

Štítky

Příznaky

Mezinárodní význam, Recenzováno
Změněno: 25. 3. 2015 17:07, Ing. Mgr. Věra Pospíšilíková

Anotace

V originále

BACKGROUND Several studies have shown that unnecessary right ventricular pacing has detrimental effects. OBJECTIVE To evaluate whether minimization of ventricular pacing as compared with standard dual-chamber pacing (DDD) improves clinical outcomes in patients referred for pacemaker or implantable cardioverter-defibrillator (ICD) replacement. METHODS In an international single-blind, multicenter, randomized controlled trial, we compared DDD with managed ventricular pacing (MVP), a pacing mode developed to minimize ventricular pacing by promoting intrinsic atrioventricular conduction. We included patients referred for device replacement with >40% ventricular pacing, no cardiac resynchronization therapy upgrade indication, no permanent atrial fibrillation (AF), and no permanent complete atrioventricular block. Follow-up was for 2 years. The primary end point was cardiovascular hospitalization. The intention-to-treat analysis was performed by using Kaplan-Meier method and the log-rank test. RESULTS We randomized 605 patients (556 referred for pacemaker and 49 referred for ICD replacement; mean age 75 +/- 11 years; 365 [60%] men, at 7.7 +/- 3.3 years from first device implantation) to MVP (n = 299) or DDD (n = 306). We found no significant differences in the primary end point cardiovascular hospitalization (MVP: 16.3% vs DDD: 14.5 /0; P =.72) and the secondary end point persistent AF (MVP: 15.4% vs DDD: 11.2 /a; P =.08), permanent AF (MVP: 4.1% vs DDD: 3.1%; P =.44), and composite of death and cardiovascular hospitalization (MVP: 23.9% vs DDD: 20.2%; P =.48). MVP reduced right ventricular pacing (median 5% vs 86%; Wilcoxon, P <.0001) as compared with DOD. CONCLUSIONS In patients referred for pacemaker and ICD replacement with clinically well-tolerated long-term exposure to >40% ventricular pacing in the ventricle, a strategy to minimize ventricular pacing is not superior to standard DDD in reducing incidence of cardiovascular hospitalizations.