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

2015 HRS/EHRA/APHRS/SOLAECE expert consensus statement on optimal implantable cardioverter-defibrillator programming and testing

“…Consistently, every 1% increase in biventricular pacing percentage was associated with a 6% risk reduction in HF or death, a 10% risk reduction in death alone, and an increase in LV reverse remodeling [67]. Therefore, in ICD patients with biventricular pacing, it can be beneficial to adjust the therapy to produce the highest achievable percentage of ventricular PreFER MVP, randomized multicenter (2014) [46] 605 (556PM, 49 ICD) No difference between cardiovascular hospitalization, AF, and the composite of death and hospitalization between the MVP and DDD groups. The authors stated that "patients were enrolled upon elective replacement of the device, and were healthy enough to survive the first device without experiencing a significant decrease in LV function."…”

Reducing Ventricular Pacing Frequency in Patients With Atrioventricular Block

“…Lim 37 has recently indicated that this algorithm should be confined to patients in sinus rhythm with SND, narrow QRS (<120 ms), and no significant AV conduction disease, and that patients with second-or third-degree AVB should not be prescribed MVP. The recently published prospective, randomized PREFER MVP study (Prefer MVP for Elective Replacement) has indicated that the lack of adequate PR management can be detrimental to patients 11,12 : 605 patients referred for generator replacement of a pacemaker or ICD were enrolled if they had a history of >40% VP. Patients were allocated to receive either standard DDD or MVP pacing.…”

“…Patients were allocated to receive either standard DDD or MVP pacing. 11 A secondary analysis of the study 12 showed that history of atrial arrhythmias and VP% ≥10%, estimated in the first 3 months, were independent predictors for persistent atrial arrhythmias observed in 71 patients (11.7%) after 2 years of follow-up, and that MVP was associated with an increased risk of persistent atrial arrhythmias (hazard ratio [HR], 3.41; 95% confidence interval, 1.10-10.6; P=0.024) in the subgroup of patients with baseline long PR interval (PR>230 ms). This is consistent with the results from the earlier study of Sweeney et al 36 The SafeR algorithm was designed to manage PR prolongation in patients with AVB as long as in patients with other atrioventricular conduction disorders (Figure 2).…”

“…Because the most common indication for permanent pacing is intermittent or persistent complete atrioventricular block (AVB) 7 (Web Table 3-ESC GDL 2013); the value of reducing VP has not been tested adequately in this patient group until recently (Table 1). [9][10][11][12][13][14][15][16][17][18][19][20][21][22] New studies have evaluated the use of an algorithm limiting the frequency of VP in patients with advanced or complete AVB (Table 1). The purpose of the present review is to report the recent apparently contradictory data suggesting more aggressively adopting algorithms that reduce the frequency of ventricular pacing in patients with AVB-a population for whom we have typically programmed continuous and uninterrupted ventricular pacing.…”

Current possibilities of permanent pacing for prevention of atrial fibrillation and heart failure progression

“…Не было выявлено статистически значимого различия между группами в частоте госпитализаций по сердечно-сосуди-стым причинам (p=0,72), развитии персистирующей (p=0,08) и постоянной формы ФП (p=0,44), а также в до-стижении комбинированной конечной точки, включаю-щей смертность и госпитализацию по сердечно-сосуди-стым причинам (p=0,48). Авторы данного исследования сделали вывод, что у пациентов, нуждающихся в плано-вой замене ЭКС, и при этом клинически толерантных к длительному (более 40% времени) воздействию ПЖ апи-кальной стимуляции, стратегия по уменьшению частоты ПЖ стимуляции не приводит к снижению частоты госпи-тализаций по сердечно-сосудистым причинам по сравне-нию со стандартной двухкамерной стимуляцией [4]. Сле-довательно, нет причин стремиться использовать данные режимы стимуляции у данной группы пациентов.…”