Near Elimination of Ventricular Pacing in SafeR Mode Compared to DDD Modes: A Randomized Study of 422 Patients

Davy, Jean‐Marc; Hoffmann, Ellen; Frey, Axel W.; Jocham, K.; Rossi, Stefano; Dupuis, Jean‐Marc; Frabetti, L; Ducloux, Pascale; Prades, Emmanuel; Jauvert, Gaël

doi:10.1111/j.1540-8159.2011.03314.x

Cited by 23 publications

(12 citation statements)

References 33 publications

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“…Clinical and echocardiographic variables were as expected for a cohort of patients with an average of 10 years of RV pacing 10. Patients in AF were more likely to have symptoms (63% vs 51% in NYHA class II; χ 2 =6.0; p<0.05), larger hearts (LV end-diastolic diameter (LVEDD) 55 mm (52–57) vs 49 (46–51); p=0.003) and higher baseline NT-pro-BNP levels (1778 (IQR ng/L 2366) vs 485 (IQR 1301); p=0.003), but LVEF, past medical history and medical therapy were the same across AF and SR patients.…”

Section: Resultssupporting

confidence: 67%

Pacing-associated left ventricular dysfunction? Think reprogramming first!

Gierula

Jamil

Byrom

et al. 2014

Heart

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Section: Resultssupporting

confidence: 67%

Pacing-associated left ventricular dysfunction? Think reprogramming first!

Gierula

Jamil

Byrom

et al. 2014

Heart

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“…In the meantime, this risk has been substantially reduced by the introduction of algorithms to minimize ventricular pacing (37)(38)(39) Values are n (%). *Patients in the single-chamber setting group would not have received atrial leads in clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Reduced Risk for Inappropriate Implantable Cardioverter-Defibrillator Shocks With Dual-Chamber Therapy Compared With Single-Chamber Therapy

Kolb

Sturmer

Sick³

et al. 2014

JACC: Heart Failure

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Therapy with dual-chamber settings for ICD discrimination combined with algorithms for minimizing ventricular pacing was associated with reduced risk for inappropriate shock compared with single-chamber settings, without increases in mortality and morbidity. (Optimal Anti-Tachycardia Therapy in Implantable Cardioverter-Defibrillator [ICD] Patients Without Pacing Indications [OPTION]; NCT00729703).

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“…The SafeR algorithm (Sorin CRM, Clamart, France) was developed to provide a pacing mode that combines the benefits of AAI with the safety of DDD pacing . The recent randomized SaveR study confirmed the superiority of SafeR in reducing RV pacing when compared to standard DDD pacing in selected patients without high‐degree AV block and in a more general pacemaker population.…”

Section: Introductionmentioning

confidence: 99%

Very Low Ventricular Pacing Rates Can Be Achieved Safely in a Heterogeneous Pacemaker Population and Provide Clinical Benefits: The CANadian Multi‐Centre Randomised Study‐Spontaneous AtrioVEntricular Conduction pReservation (CAN‐SAVE R) Trial

Thibault

Ducharme

Baranchuk

et al. 2015

JAHA

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BackgroundIt is well recognized that right ventricular apical pacing can have deleterious effects on ventricular function. We performed a head-to-head comparison of the SafeR pacing algorithm versus DDD pacing with a long atrioventricular delay in a heterogeneous population of patients with dual-chamber pacemakers.Methods and ResultsIn a multicenter prospective double-blinded randomized trial conducted at 10 centers in Canada, 373 patients, age 71±11 years, with indications for dual chamber DC pacemakers were randomized 1:1 to SafeR or DDD pacing with a long atrioventricular delay (250 ms). The primary objective was twofold: (1) reduction in the proportion of ventricular paced beats at 1 year; and (2) impact on atrial fibrillation burden at 3 years, defined as the ratio between cumulative duration of mode-switches divided by follow-up time. Statistical significance of both co-primary end points was required for the trial to be considered positive. At 1 year of follow-up, the median proportion of ventricular-paced beats was 4.0% with DDD versus 0% with SafeR (P<0.001). At 3 years of follow-up, the atrial fibrillation burden was not significantly reduced with SafeR versus DDD (median 0.00%, interquartile range [0.00% to 0.23%] versus median 0.01%, interquartile range [0.00% to 0.44%], respectively, P=0.178]), despite a persistent reduction in the median proportion of ventricular-paced beats (10% with DDD compared to 0% with SafeR).ConclusionsA ventricular-paced rate <1% was safely achieved with SafeR in a population with a wide spectrum of indications for dual-chamber pacing. However, the lower percentage of ventricular pacing did not translate into a significant reduction in atrial fibrillation burden.Clinical Trial RegistrationURL: https://www.clinicaltrials.gov/ Unique identifier: NCT01219621.

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Near Elimination of Ventricular Pacing in SafeR Mode Compared to DDD Modes: A Randomized Study of 422 Patients

Abstract: In this selected patient population, SafeR markedly suppressed unnecessary Vp compared with DDD modes.

Cited by 23 publications

References 33 publications

Pacing-associated left ventricular dysfunction? Think reprogramming first!

Pacing-associated left ventricular dysfunction? Think reprogramming first!

Reduced Risk for Inappropriate Implantable Cardioverter-Defibrillator Shocks With Dual-Chamber Therapy Compared With Single-Chamber Therapy

Very Low Ventricular Pacing Rates Can Be Achieved Safely in a Heterogeneous Pacemaker Population and Provide Clinical Benefits: The CANadian Multi‐Centre Randomised Study‐Spontaneous AtrioVEntricular Conduction pReservation (CAN‐SAVE R) Trial

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