Reduction of Right Ventricular Pacing in Patients with Dual‐Chamber ICDs

Olshansky, Brian; Day, John D.; McGuire, Maureen; Hahn, Stephen J.; Brown, Scott A.; Lerew, Darin R.

doi:10.1111/j.1540-8159.2006.00329.x

Cited by 30 publications

(16 citation statements)

References 17 publications

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“…In another randomized, crossover study in unselected pacemaker recipients, ventricular pacing was decreased from a median of nearly 90% in DDD mode, to less than 2% in the managed ventricular pacing mode through a 1‐month follow‐up period 24 . A third randomized trial compared VVI versus DDD pacing with AV search hysteresis in a population of ICD recipients and showed a moderated reduction in mean ventricular pacing while extending AV delay extension to 100% 25 . In the present study, we demonstrated a significant reduction in mean ventricular pacing in SafeR (3.4 ± 12.6%) as compared to both DDD modes at 2 months follow‐up.…”

Section: Discussionmentioning

confidence: 99%

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

Davy

Hoffmann

Frey

et al. 2012

Pacing Clinical Electrophis

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Section: Discussionmentioning

confidence: 99%

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

Davy

Hoffmann

Frey

et al. 2012

Pacing Clinical Electrophis

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“…This retrospective analysis examined all INTRINSIC RV trial subjects with age documented in the database. Methods and results have been reported previously [10]. Enrolled patients provided informed consent prior to ICD implantation.…”

Section: Methodsmentioning

confidence: 99%

Older Persons with Diabetes Receive Fewer Inappropriate ICD Shocks: Results from the INTRINSIC RV Trial

Sandesara

Sullivan

Russo

et al. 2010

J. of Cardiovasc. Trans. Res.

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In patients with heart disease, diabetes and age predict adverse outcomes. It remains unclear whether persons with diabetes who have implantable cardioverter defibrillators (ICDs) have fewer appropriate and inappropriate ICD shocks. The objective of this study is to determine if persons with diabetes who have ICDs receive a similar amount of appropriate and inappropriate shocks compared to persons without diabetes. In a post hoc analysis of 1,528 patients enrolled in the INTRINSIC RV trial, all-cause mortality and ICD shocks between persons with and without diabetes, stratified by age, was compared. The relationship between shock and mortality was also assessed. Mortality 1 year after ICD implant was lower for persons without diabetes vs. persons with diabetes (3.5% vs. 7.9%, p < 0.001). Young and old persons with diabetes received a similar number of total and appropriate ICD shocks. However, older persons with diabetes were less likely to receive inappropriate ICD shocks vs. older persons without diabetes (1.9% vs. 6.9%, p < 0.01). ICD shocks were not temporally related to mortality regardless of diabetes status. In the INTRINSIC RV trial, persons with diabetes and older persons without diabetes undergoing ICD implant were at a higher risk of death. Older persons with diabetes received less inappropriate shocks and still had a similar amount of appropriate shocks compared to persons without diabetes of similar age.

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“…8 If the right ventricle was paced Ͼ20% of the time, the patient was not randomized but rather was placed in an observational arm. The protocol specified a 12-month follow-up period with an actual mean of 10.4 months.…”

Section: Methodsmentioning

confidence: 99%

Heart Rate Predicts Outcomes in an Implantable Cardioverter-Defibrillator Population

et al. 2009

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on behalf of the INTRINSIC RV Study InvestigatorsBackground-Elevated heart rate (HR) is associated with adverse cardiovascular events and total mortality in the general population and in individuals with heart disease. Our hypothesis was that mean HR predicts total mortality and heart failure hospitalization in patients undergoing implantable cardioverter-defibrillator (ICD) implantation. Methods and Results-The Inhibition of Unnecessary RV Pacing With AV Search Hysteresis in ICDs (INTRINSIC RV) trial included 1530 patients undergoing ICD implantation. After implantation of a dual-chamber ICD, patients were followed for a mean of 10.4 months. The mean HR for 1436 patients over the follow-up period was determined from device histograms. Patients were grouped into strata by mean HR, and the relationship between the primary end point and mean HR was analyzed with Mantel-Haenszel ordinal 2 tests. Higher intrinsic (unpaced) HR was associated with greater risk of achieving the primary end point of death or heart failure hospitalization (PϽ0.001). Of patients with a mean HR Ͻ75 bpm, 5.8% died or were hospitalized for heart failure, whereas 20.9% with a mean HR Ͼ90 bpm achieved the same end point, a 3.6-fold difference (PϽ0.0001). In a multivariate model with the use of Cox regression, HR was a significant predictor with a hazard ratio of 1.34 (Pϭ0.0001; 95% confidence interval, 1.19 to 1.50), as were age, New York Heart Association functional class, and percent right ventricular pacing, but it was independent of gender and ␤-blocker dosing. When considered as continuous or discrete variables grouped by 5-bpm increments, HR remained a significant predictor. Conclusions-In this ICD population, the mean intrinsic HR was strongly associated with outcomes. Clinical Trial Registration-http://www.clinicaltrials.gov.

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Reduction of Right Ventricular Pacing in Patients with Dual‐Chamber ICDs

Abstract: AVSH can dramatically reduce the percentage of RV pacing among ICD recipients.

Cited by 30 publications

References 17 publications

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

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

Older Persons with Diabetes Receive Fewer Inappropriate ICD Shocks: Results from the INTRINSIC RV Trial

Heart Rate Predicts Outcomes in an Implantable Cardioverter-Defibrillator Population

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