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.