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Comparison of two strategies to reduce ventricular pacing in pacemaker patients

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Author

  • Helmut Puererfellner
  • Johan Brandt
  • Carsten Israel
  • Todd Sheldon
  • James Johnson
  • Karlheinz Tscheliessnigg
  • Johannes Sperzel
  • Giuseppe Boriani
  • Andrea Puglisi
  • Goran Milasinovic

Summary, in English

Background: Managed Ventricular Pacing (MVP) and Search AV+ (SAV+) are two pacing algorithms designed to reduce ventricular pacing, MVP promotes conduction by operating in AAI/R mode with backup ventricular pacing during atrioventricular block (AVB). SAV+ operates in DDD/R mode with a nominal AV extension of 290 ms during atrial sensing and 320 ms during atrial pacing. The reduction in ventricular pacing was compared with these two algorithms in pacemaker patients. Methods: The EnRhythm and EnPulse clinical studies assessed the Percentage of ventricular pacing (% VP) after 1 month. Each patient's AVB status was assigned using the following hierarchical categories: persistent third-degree AVB (p3AVB), episodic third-degree AVB (e3AVB), second-degree AVB (2AVB), first-degree AVB (1AVB), and no AVB (nAVB). The% VP was tabulated for each AVB status category. Results: Data were available from 322 patients of whom 129 received DDD(R) pacing with the MVP algorithm activated and 193 patients with DDD(R) pacing and the SAV+ function activated, each for a month period. MVP resulted in a significantly lower median % VP than SAV+ in all AVB categories except for p3AVB: nAVB (0.3 vs 2.9, P < 0.0001), 1AVB (0.9% vs 80.6%. P < 0.0001), 2AVB (37.6 vs 99.3. P < 0.002), e3AVB (1.2 vs 42.2, P = 0.02), p3AVB (98.9 vs 100, P = 1.00). Conclusion: MVP resulted in a greater reduction in% VP than SAV+ across all patient groups except persistent third-degree AV block. The greatest reduction in%VP was observed in patients with mildly impaired AV conduction.

Department/s

Publishing year

2008

Language

English

Pages

167-176

Publication/Series

PACE

Volume

31

Issue

2

Document type

Journal article

Publisher

Wiley-Blackwell

Topic

  • Cardiac and Cardiovascular Systems

Keywords

  • intrinsic AV conduction
  • ventricular pacing
  • AV block
  • pacing algorithms

Status

Published

ISBN/ISSN/Other

  • ISSN: 1540-8159