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Comparison of two strategies to reduce ventricular pacing in pacemaker patients

Puererfellner, Helmut; Brandt, Johan LU ; Israel, Carsten; Sheldon, Todd; Johnson, James; Tscheliessnigg, Karlheinz; Sperzel, Johannes; Boriani, Giuseppe; Puglisi, Andrea and Milasinovic, Goran (2008) In PACE 31(2). p.167-176
Abstract
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),... (More)
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. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
intrinsic AV conduction, ventricular pacing, AV block, pacing algorithms
in
PACE
volume
31
issue
2
pages
167 - 176
publisher
Wiley-Blackwell
external identifiers
  • wos:000253676000006
  • scopus:38849110690
ISSN
1540-8159
DOI
10.1111/j.1540-8159.2007.00965.x
language
English
LU publication?
yes
id
3b1b4b82-7782-40fa-9526-84751dad02ac (old id 1192782)
date added to LUP
2008-09-09 08:49:49
date last changed
2017-06-04 04:13:12
@article{3b1b4b82-7782-40fa-9526-84751dad02ac,
  abstract     = {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 &lt; 0.0001), 1AVB (0.9% vs 80.6%. P &lt; 0.0001), 2AVB (37.6 vs 99.3. P &lt; 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.},
  author       = {Puererfellner, Helmut and Brandt, Johan and Israel, Carsten and Sheldon, Todd and Johnson, James and Tscheliessnigg, Karlheinz and Sperzel, Johannes and Boriani, Giuseppe and Puglisi, Andrea and Milasinovic, Goran},
  issn         = {1540-8159},
  keyword      = {intrinsic AV conduction,ventricular pacing,AV block,pacing algorithms},
  language     = {eng},
  number       = {2},
  pages        = {167--176},
  publisher    = {Wiley-Blackwell},
  series       = {PACE},
  title        = {Comparison of two strategies to reduce ventricular pacing in pacemaker patients},
  url          = {http://dx.doi.org/10.1111/j.1540-8159.2007.00965.x},
  volume       = {31},
  year         = {2008},
}