Reducing Unnecessary Right Ventricular Pacing with the Managed Ventricular Pacing Mode in Patients with Sinus Node Disease and AV Block

Gillis, Anne M.; Pürerfellner, Helmut; Israel, Carsten W.; Sunthorn, Henri; Kacet, Salem; Anelli-Monti, M.; Tang, Feng; Young, Martin E.; Boriani, Giuseppe

doi:10.1111/j.1540-8159.2006.00422.x

Cited by 145 publications

(78 citation statements)

References 29 publications

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“…The feasibility of algorithms designed to decrease the burden of unnecessary ventricular pacing has been demonstrated in patients with dual-chamber pacemakers [36][37][38]. These algorithms usually provide functional AAI pacing with monitoring of atrioventricular conduction and an automatic mode switch from AAI to DDD during episodes of atrioventricular block.…”

Section: Non-crt Devices: Algorithms To Reduce Right Ventricular Stimmentioning

confidence: 99%

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

et al. 2016

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Section: Non-crt Devices: Algorithms To Reduce Right Ventricular Stimmentioning

confidence: 99%

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

et al. 2016

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“…For patients with AVB that have some intrinsic conduction, atrial-based minimal ventricular pacing mode in DDD devices may help to reduce unnecessary RV pacing. 54 overall, however, the one size fits all approach to ventricular pacing in this population is not supported by available trial data, which does not support universal biventricular pacing. Arenas et al have nicely summarized much of the information we have on dual chamber (DDD) and biventricular pacing.…”

Section: Arenas Et Al Biventricular Pacing In Patients With Heart Blomentioning

confidence: 87%

Routine Use of Biventricular Pacing Is Not Warranted for Patients With Heart Block

Arenas

Jacobson

Lamas

2015

Circ: Arrhythmia and Electrophysiology

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“…This type of pacing causes an abnormal left ventricular electricalactivation sequence with an electromechanical delay in contraction (right to left ventricle dyssynchrony) and, subsequently, increased mitral regurgitation and decreased EF (17)(18)(19)(20). Several preventive pacing algorithms have been developed to reduce the percentage of right ventricular pacing but these might be used only in patients with sinus node dysfunction, not in patients with advanced AV block and a high percentage of ventricular pacing (21,22). In elderly patients with underlying risk factors for heart failure (diastolic dysfunction and comorbidities), more than 50% of RV apical pacing may trigger the complications (23).…”

Section: Discussionmentioning

confidence: 99%

TUGENDHAT: a pilot randomized study on effects of biventricular pacing in patients with bradycardia pacing indication and normal systolic function on heart failure, atrial fibrillation and quality of life (results of 12 month follow-up)

Táborský

Ríhová²,

Mráz³

et al. 2013

BLL

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Abstract:Background: Since the late 1990s, a growing number of clinical studies have indicated that long-term permanent right ventricular (RV) apical pacing will induce severe complications such as development of heart failure, increased burden of atrial fi brillation leading to decreased quality of life. Aim of the study: To investigate whether cardiac resynchronization therapy (CRT) using biventricular (BiV) pacing can prevent the development of left ventricular (LV) dysfunction, LV remodelling, worsening of the clinical status and quality of life in chronically RV paced patients with normal LV ejection fraction (EF). Methods and results:A total of 127 patients with Class I indication for permanent cardiac pacing and without established indication for CRT were subjected to 6 months of RV and BiV pacing in a patient-blinded, randomized crossover trial. Treatment effects of BiV pacing were evaluated for LV function, LV remodelling and clinical status. Conclusion: BiV pacing, compared to RV pacing, did not change LV function and quality of life in patients with the absence of LV dysfunction or remodelling, standard bradycardia pacing indications in a pilot phase (12-month follow-up) of the TUGENDHAT trial. The fi nal report will be published after 60-month follow-up termination (Tab. 5, Fig. 3, Ref. 30). Full Text in PDF www.elis.sk. Key words: BiV and RV pacing, LV remodelling, heart failure, atrial fi brillation, quality of life. Results of several trials have supported the fact that right ventricular (RV) apical pacing might lead to adverse clinical outcomes in patients with standard pacing indications. Nevertheless, RV apical pacing continues to be practiced by many physicians because of its easy accessibility and relative stability over time (1, 2). The optimal mode and site of pacing remain undefi ned.The detrimental effect of RV pacing is probably most important in patients with pre-existing left ventricular (LV) dysfunction and may lead to worsening of heart failure (3, 4). In RV pacing, the sequence of electrical activation resembles the activation pattern in left bundle branch block (LBBB). This asynchronous electrical pattern is accompanied by abnormal dyssynchronous mechanical interactions within the LV (5). Experimental data suggested that biventricular (BiV) pacing might preserve myocardial performance better than RV apical pacing in patients with atrioventricular (AV) block and normal systolic function (6). The underlying mechanism may be a signifi cant reduction in LV systolic dyssynchrony, as shown by Cojoc et al (7). In the majority of patients with severe LV dysfunction and severe clinical heart failure associated with either LBBB-or RV pacing-induced dyssynchrony, BiV pacing improves clinical status, reduces mortality and morbidity, reduces heart failure (HF) hospitalizations, reverses LV remodelling and improves LV function (8, 9). Therefore, BiV pacing is nowadays recommended in patients with ventricular dyssynchrony (QRS > 120 ms), severe LV dysfunction [LV ejection fraction (LVEF) < 0.35] ...

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Reducing Unnecessary Right Ventricular Pacing with the Managed Ventricular Pacing Mode in Patients with Sinus Node Disease and AV Block

Cited by 145 publications

References 29 publications

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

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

Routine Use of Biventricular Pacing Is Not Warranted for Patients With Heart Block

TUGENDHAT: a pilot randomized study on effects of biventricular pacing in patients with bradycardia pacing indication and normal systolic function on heart failure, atrial fibrillation and quality of life (results of 12 month follow-up)

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