Reduction of Right Ventricular Pacing with Advanced Atrioventricular Search Hysteresis: Results of the PREVENT Study.
Background: Right ventricular pacing predisposes to the development of heart failure and atrial fibrillation. Automatic atrioventricular search hysteresis (AVSH) is a commonly used strategy to decrease the percentage of right ventricular pacing (%VP) in patients without permanent AV block, but the r...
| Publicado en: | Pacing & Clinical Electrophysiology Vol. 34; no. 8; pp. 975 - 984 |
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| Autores principales: | , , , , , , , , , , , , |
| Formato: | research tables/charts tracings randomized controlled trial Journal Article |
| Publicado: |
Wiley-Blackwell
Aug2011
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104674002&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104674002 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01478389 4F8 jtl: Pacing & Clinical Electrophysiology issn: 01478389 maglogo: Y pubinfo: dt: Aug2011 vid: 34 iid: 8 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 104674002 64438066 10.1111/j.1540-8159.2011.03075.x NLM21438891 104674002 ppf: 975 ppct: 9 formats: fmt: @attributes: type: P tig: atl: Reduction of Right Ventricular Pacing with Advanced Atrioventricular Search Hysteresis: Results of the PREVENT Study. aug: au: Kolb, Christof Schmidt, Roland Dietl, Josef U. Weyerbrock, Sonja Morgenstern, Martin Fleckenstein, Martin Beier, Thomas Von Bary, Christian Mackes, Karl G. Widmaier, Jochen Kreuzer, JÖRg Semmler, Verena Zrenner, Bernhard affil: Deutsches Herzzentrum and 1. Medizinische Klinik rechts der Isar, Faculty of Medicine, Technische Universität München, Munich, Germany sug: subj: Pacemaker, Artificial Methods Heart Ventricle, Right Physiopathology Heart Block Physiopathology Randomized Controlled Trials Human Crossover Design Descriptive Statistics Confidence Intervals Germany Wilcoxon Rank Sum Test McNemar's Test Data Analysis Software Middle Age Aged Aged, 80 and Over Male Female Treatment Outcomes Algorithms Funding Source Middle Aged: 45-64 years Aged: 65+ years Aged, 80 & over Male Female ab: Background: Right ventricular pacing predisposes to the development of heart failure and atrial fibrillation. Automatic atrioventricular search hysteresis (AVSH) is a commonly used strategy to decrease the percentage of right ventricular pacing (%VP) in patients without permanent AV block, but the results have not been optimal. Methods: The randomized, crossover PREVENT study evaluated whether an enhanced AVSH with two new features can reduce %VP compared with standard AVSH. The new features are the repetitive hysteresis [switch from extended to basic AV delay after a consistent loss of intrinsic AV conduction (IAVC) lasting for six consecutive atrial cycles] and the scan hysteresis (periodic IAVC search extension over six consecutive atrial cycles). Both standard AVSH and enhanced AVSH performed a periodic IAVC search every 180 cardiac cycles and operated with a basic AV-delay of 225 ms and a rate-independent maximum AV-delay of 300 ms for paced and sensed atrial events. Results: Among 178 patients, 53.4% had no evidence of AV block at enrollment and 46.6% had history of intermittent AV block. The median %VP was decreased by enhanced AVSH compared to standard AVSH (4.0% vs 5.5%, P < 0.001), particularly in patients with a history of AV block (21.4% vs 25.5%, P < 0.001). The primary study hypothesis that 25% of all patients would experience > 20% relative %VP reduction was not met as 46 (25.8%) patients (95% confidence interval, 20.5-31.8%) presented such relative reduction. Conclusion: The enhanced AVSH algorithm reduces %VP compared with standard AVSH in patients with intermittent AV block. (PACE 2011; 34:975-983) pubtype: Academic Journal doctype: research tables/charts tracings randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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