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

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.

Basic information

Original name

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

Authors

BOTTO, Giovanni L. (380 Italy); Renato P. RICCI (380 Italy); Juan M. BENEZET (724 Spain); Jens Cosedis NIELSEN (208 Denmark); Luc DE ROY (56 Belgium); Olivier PIOT (250 France); Aurelio QUESADA (724 Spain); Raffaele QUAGLIONE (380 Italy); Diego VACCARI (380 Italy); Claudio GARUTTI (528 Netherlands); Lidwien VAINER (528 Netherlands) and Milan KOZÁK (203 Czech Republic, guarantor, belonging to the institution)

Edition

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

Other information

Language

English

Type of outcome

Article in a journal

Field of Study

30201 Cardiac and Cardiovascular systems

Country of publisher

United States of America

Confidentiality degree

is not subject to a state or trade secret

Impact factor

Impact factor: 5.076

RIV identification code

RIV/00216224:14110/14:00079796

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1016/j.hrthm.2014.03.011

UT WoS

000336395600013

Keywords in English

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

Abstract

In the original language

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.

Cite

BOTTO, Giovanni L.; Renato P. RICCI; Juan M. BENEZET; Jens Cosedis NIELSEN; Luc DE ROY; Olivier PIOT; Aurelio QUESADA; Raffaele QUAGLIONE; Diego VACCARI; Claudio GARUTTI; Lidwien VAINER and Milan KOZÁK. 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. Heart Rhythm. New York: Elsevier Science, 2014, vol. 11, No 6, p. 992-1000. ISSN 1547-5271. Available from: https://dx.doi.org/10.1016/j.hrthm.2014.03.011.

@article{1231818,
   author = {Botto, Giovanni L. and Ricci, Renato P. and Benezet, Juan M. and Nielsen, Jens Cosedis and De Roy, Luc and Piot, Olivier and Quesada, Aurelio and Quaglione, Raffaele and Vaccari, Diego and Garutti, Claudio and Vainer, Lidwien and Kozák, Milan},
   article_location = {New York},
   article_number = {6},
   doi = {http://dx.doi.org/10.1016/j.hrthm.2014.03.011},
   keywords = {Cardiac pacing; Managed ventricular pacing; Dual-chamber pacing; Randomized controlled trial; Outcomes},
   language = {eng},
   issn = {1547-5271},
   journal = {Heart Rhythm},
   title = {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},
   volume = {11},
   year = {2014}
}

TY  - JOUR
ID  - 1231818
AU  - Botto, Giovanni L. - Ricci, Renato P. - Benezet, Juan M. - Nielsen, Jens Cosedis - De Roy, Luc - Piot, Olivier - Quesada, Aurelio - Quaglione, Raffaele - Vaccari, Diego - Garutti, Claudio - Vainer, Lidwien - Kozák, Milan
PY  - 2014
TI  - 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
JF  - Heart Rhythm
VL  - 11
IS  - 6
SP  - 992-1000
EP  - 992-1000
PB  - Elsevier Science
SN  - 15475271
KW  - Cardiac pacing
KW  - Managed ventricular pacing
KW  - Dual-chamber pacing
KW  - Randomized controlled trial
KW  - Outcomes
N2  - 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.
ER  -

BOTTO, Giovanni L.; Renato P. RICCI; Juan M. BENEZET; Jens Cosedis NIELSEN; Luc DE ROY; Olivier PIOT; Aurelio QUESADA; Raffaele QUAGLIONE; Diego VACCARI; Claudio GARUTTI; Lidwien VAINER and Milan KOZÁK. 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. \textit{Heart Rhythm}. New York: Elsevier Science, 2014, vol.~11, No~6, p.~992-1000. ISSN~1547-5271. Available from: https://dx.doi.org/10.1016/j.hrthm.2014.03.011.

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