The effect of atrial pacing therapies on atrial tachyarrhythmia burden and frequency

Lee, Michael A.; Weachter, Richard; Pollak, Scott J.; Kremers, Mark S.; Naik, Ajay; Silverman, Russell; Tuzi, Joann; Wang, Wayne; Johnson, Linda J.; Euler, David E.; Investigators, Attest

doi:10.1016/s0735-1097(03)00426-1

Cited by 186 publications

(22 citation statements)

References 9 publications

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“…4,6,30–32 Two recent trials, such as the ASSERT and the SAFE studies, did not find a substantial benefit of continuous atrial overdrive pacing in preventing AF occurrence. 4,30 However, it is important to note that both these studies tested only one prevention algorithm, while MINERVA trial tested three preventive algorithms together with aATP and MVP.…”

Section: Discussionmentioning

confidence: 99%

Atrial antitachycardia pacing and managed ventricular pacing in bradycardia patients with paroxysmal or persistent atrial tachyarrhythmias: the MINERVA randomized multicentre international trial

et al. 2014

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AimsAtrial fibrillation (AF) is a common comorbidity in bradycardia patients. Advanced pacemakers feature atrial preventive pacing and atrial antitachycardia pacing (DDDRP) and managed ventricular pacing (MVP), which minimizes unnecessary right ventricular pacing. We evaluated whether DDDRP and MVP might reduce mortality, morbidity, or progression to permanent AF when compared with standard dual-chamber pacing (Control DDDR).Methods and resultsIn a randomized, parallel, single-blind, multi-centre trial we enrolled 1300 patients with bradycardia and previous atrial tachyarrhythmias, in whom a DDDRP pacemaker had recently been implanted. History of permanent AF and third-degree atrioventricular block were exclusion criteria. After a 1-month run-in period, 1166 eligible patients, aged 74 ± 9 years, 50% females, were randomized to Control DDDR, DDDRP + MVP, or MVP. Analysis was intention-to-treat.The primary outcome, i.e. the 2-year incidence of a combined endpoint composed of death, cardiovascular hospitalizations, or permanent AF, occurred in 102/385 (26.5%) Control DDDR patients, in 76/383 (19.8%) DDDRP + MVP patients [hazard ratio (HR) = 0.74, 95% confidence interval 0.55–0.99, P = 0.04 vs. Control DDDR] and in 85/398 (21.4%) MVP patients (HR = 0.89, 95% confidence interval 0.77–1.03, P = 0.125 vs. Control DDDR). When compared with Control DDDR, DDDRP + MVP reduced the risk for AF longer than 1 day (HR = 0.66, 95% CI 0.52–0.85, P < 0.001), AF longer than 7 days (HR = 0.52, 95% CI 0.36–0.73, P < 0.001), and permanent AF (HR = 0.39, 95% CI 0.21–0.75, P = 0.004).ConclusionIn patients with bradycardia and atrial tachyarrhythmias, DDDRP + MVP is superior to standard dual-chamber pacing. The primary endpoint was significantly lowered through the reduction of the progression of atrial tachyarrhythmias to permanent AF.ClinicalTrials.gov IdentifierNCT00262119.

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Section: Discussionmentioning

confidence: 99%

Atrial antitachycardia pacing and managed ventricular pacing in bradycardia patients with paroxysmal or persistent atrial tachyarrhythmias: the MINERVA randomized multicentre international trial

et al. 2014

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“…The ATTEST trial evaluated three different algorithms for AF prevention (Atrial Preference Pacing, Atrial Rate Stabilization and Post Mode Switching Overdrive), and showed no difference in total number of AF episodes or median AF burden between patients with either the algorithms switched "on" or "off" [39]. The PIPAF trial had similar results, showing no difference in number of AF paroxysms per week in a crossover population during a 3 months follow up [40].…”

Section: Trigger Suppression Algorithmsmentioning

confidence: 99%

“…Efficacy of atrial ATP is low, mainly because of the aforementioned mechanisms, and it varies from 30 to 54% [39]. However, several variables must be taken into account.…”

Section: Atrial Pacing For Af Terminationmentioning

confidence: 99%

Implanted Devices and Atrial Fibrillation

Guerra¹,

Brambatti²,

Matassini³

et al. 2012

Current Issues and Recent Advances in Pacemaker Therapy

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“…Paroxysmale Vorhoftachyarrhythmien stellen nach negativen Studienergebnissen [16,17,18,19,20,21] keine primäre Schrittmacherindikation dar. Die deutschen Leitlinien legen deshalb nur fest, unter welchen Bedingungen präventive Stimulation jenseits klassischer Indikationen eingesetzt werden darf (IIa-C, IIb-C); (.…”

Section: Vorhofflimmernunclassified

Kommentar zu den ESC-Leitlinien ?Guidelines for cardiac pacing and cardiac resynchronization therapy?

2008

Kardiologe

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The effect of atrial pacing therapies on atrial tachyarrhythmia burden and frequency

Abstract: This DDDRP pacemaker is safe, has accurate AT/AF detection, and provides ATP with 54% efficacy as defined by the device. The atrial prevention and termination therapies combined did not reduce AT/AF burden or frequency in this patient population.

Cited by 186 publications

References 9 publications

Atrial antitachycardia pacing and managed ventricular pacing in bradycardia patients with paroxysmal or persistent atrial tachyarrhythmias: the MINERVA randomized multicentre international trial

Atrial antitachycardia pacing and managed ventricular pacing in bradycardia patients with paroxysmal or persistent atrial tachyarrhythmias: the MINERVA randomized multicentre international trial

Implanted Devices and Atrial Fibrillation

Kommentar zu den ESC-Leitlinien ?Guidelines for cardiac pacing and cardiac resynchronization therapy?

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