A Bauer1, J Vermeulen2, L Toivonen3, J Voitk4, C Barr5, P Peytchev6. 1. Department of Cardiology, Diakonieklinikum Schwäbisch Hall/Klinikum Crailsheim, Diakoniestrasse 12, 74523, Schwäbisch Hall, Germany. alexander.bauer@dasdiak.de. 2. AZ Sint Dimpna, Geel, Belgium. 3. Helsinki University Central Hospital, Helsinki, Finland. 4. Mustamae Hospital, Tallin, Estonia. 5. Russels-Hall Hospital, Dudley, United Kingdom. 6. O.L. Vrouwziekenhuis Campus, Asse, Belgium.
Abstract
INTRODUCTION: Unnecessary ventricular pacing is associated with increased morbidity and mortality. Over the years different algorithms have been developed to reduce right ventricular pacing. OBJECTIVES: Goal of the present study was to test the efficacy of the ventricular intrinsic preference (VIP) algorithm in patients with atrioventricular intact (AVi) andatrioventricular compromised (AVc) AV-conduction. METHODS: Evaluation of VIP feature in pacemaker patients (EVITA) was a multicenter, prospective, randomized trial (Trials.gov Identifier: NCT00366158). In total, 389 patients were randomized to AVc group: n = 140/132 VIP OFF/VIP On, AVi group: n = 54/63 VIP OFF/VIP ON). One-month post-implantation AV conduction testing (AVc: PR/AR interval > 210 ms) was performed. Follow-up visits occurred 6 and 12 months after DDD-pacemaker implantation. RESULTS: In AVi and AVc-patients initiation of the VIP feature significantly reduced incidence of ventricular pacing (AVi: 53 ± 38 vs. 9 ± 21%, p = 0.0001; AVc: 79 ± 31 vs. 28 ± 35%, p = 0.0001). DDD-pacemaker implantation per se significantly reduced incidence of AF in VIP ON (AVi 27 vs. 0%, p < 0.0001; AVc 29 vs. 3%, p < 0.0001) and VIP OFF patients (AVi 43 vs. 4%, p < 0.0001; AVc 33 vs. 3, p < 0.0001), without significant differences between VIP ON and OFF groups (p > 0.05). In the AVc group activation of VIP significantly reduced incidence of adverse events (AE). All-cause mortality was not significantly different in VIP ON (n = 5) and VIP OFF (n = 4, p > 0.05) patients. CONCLUSION:AV search hysteresis (VIP) markedly reduces ventricular pacing both in patients with normal AV conduction and in patients with prolonged PR interval or intermittent AV block.
RCT Entities:
INTRODUCTION: Unnecessary ventricular pacing is associated with increased morbidity and mortality. Over the years different algorithms have been developed to reduce right ventricular pacing. OBJECTIVES: Goal of the present study was to test the efficacy of the ventricular intrinsic preference (VIP) algorithm in patients with atrioventricular intact (AVi) and atrioventricular compromised (AVc) AV-conduction. METHODS: Evaluation of VIP feature in pacemaker patients (EVITA) was a multicenter, prospective, randomized trial (Trials.gov Identifier: NCT00366158). In total, 389 patients were randomized to AVc group: n = 140/132 VIP OFF/VIP On, AVi group: n = 54/63 VIP OFF/VIP ON). One-month post-implantation AV conduction testing (AVc: PR/AR interval > 210 ms) was performed. Follow-up visits occurred 6 and 12 months after DDD-pacemaker implantation. RESULTS: In AVi and AVc-patients initiation of the VIP feature significantly reduced incidence of ventricular pacing (AVi: 53 ± 38 vs. 9 ± 21%, p = 0.0001; AVc: 79 ± 31 vs. 28 ± 35%, p = 0.0001). DDD-pacemaker implantation per se significantly reduced incidence of AF in VIP ON (AVi 27 vs. 0%, p < 0.0001; AVc 29 vs. 3%, p < 0.0001) and VIP OFF patients (AVi 43 vs. 4%, p < 0.0001; AVc 33 vs. 3, p < 0.0001), without significant differences between VIP ON and OFF groups (p > 0.05). In the AVc group activation of VIP significantly reduced incidence of adverse events (AE). All-cause mortality was not significantly different in VIP ON (n = 5) and VIP OFF (n = 4, p > 0.05) patients. CONCLUSION: AV search hysteresis (VIP) markedly reduces ventricular pacing both in patients with normal AV conduction and in patients with prolonged PR interval or intermittent AV block.
Authors: H R Andersen; J C Nielsen; P E Thomsen; L Thuesen; T Vesterlund; A K Pedersen; P T Mortensen Journal: Circulation Date: 1998-09-29 Impact factor: 29.690
Authors: Rick A Veasey; Anita Arya; John Silberbauer; Vinoda Sharma; Guy W Lloyd; Nikhil R Patel; A Neil Sulke Journal: Europace Date: 2011-01-05 Impact factor: 5.214
Authors: John Silberbauer; Rick A Veasey; Nick Freemantle; Anita Arya; Lana Boodhoo; Neil Sulke Journal: Europace Date: 2009-08-06 Impact factor: 5.214
Authors: Christof Kolb; Roland Schmidt; Josef U Dietl; Sonja Weyerbrock; Martin Morgenstern; Martin Fleckenstein; Thomas Beier; Christian Von Bary; Karl G Mackes; Jochen Widmaier; Jörg Kreuzer; Verena Semmler; Bernhard Zrenner Journal: Pacing Clin Electrophysiol Date: 2011-03-25 Impact factor: 1.976
Authors: Goran Milasinovic; Johannes Sperzel; Timothy W Smith; Hardwin Mead; Johan Brandt; Wesley K Haisty; J Russell Bailey; Marc Roelke; Jay Simonson; Bart Gerritse; Jennifer Englund; Steven J Compton Journal: Pacing Clin Electrophysiol Date: 2006-04 Impact factor: 1.976
Authors: Michael O Sweeney; Anne S Hellkamp; Kenneth A Ellenbogen; Arnold J Greenspon; Roger A Freedman; Kerry L Lee; Gervasio A Lamas Journal: Circulation Date: 2003-06-02 Impact factor: 29.690
Authors: T Ishikawa; K Kimura; N Miyazaki; O Tochikubo; T Usui; M Kashiwagi; M Ishii Journal: Pacing Clin Electrophysiol Date: 1992-11 Impact factor: 1.976
Authors: H R Andersen; J C Nielsen; P E Thomsen; L Thuesen; P T Mortensen; T Vesterlund; A K Pedersen Journal: Lancet Date: 1997-10-25 Impact factor: 79.321