Adverse Effect of Ventricular Pacing on Heart Failure and Atrial Fibrillation Among Patients With Normal Baseline QRS Duration in a Clinical Trial of Pacemaker Therapy for Sinus Node Dysfunction
Why the study?
Does increased cumulative ventricular pacing increase the risk of heart failure hospitalization and atrial fibrillation in patients with sinus node dysfunction and normal baseline QRS duration?
Population
1,339 patients with sinus node dysfunction and normal baseline QRS duration from the MOST trial.
Comparison
Dual-chamber (DDDR) pacing vs Ventricular (VVIR) pacing
Design
RCT, randomized trial of DDDR versus VVIR pacing
Follow-up
6-year
Authors
Discussion
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Member takes
Implication
Minimize ventricular pacing in sinus node dysfunction to reduce heart failure risk; confirms dyssynchrony harms regardless of AV synchrony.
Structured PICO
Does increased cumulative ventricular pacing increase the risk of heart failure hospitalization and atrial fibrillation in patients with sinus node dysfunction and normal baseline QRS duration?
P
Population
1,339 patients with sinus node dysfunction (SND) and normal baseline QRS duration (<120 ms) from the MOST trial (total N=2010).
I
Intervention
Dual-chamber (DDDR) pacing
C
Comparator
Ventricular (VVIR) pacing
O
Outcome
Heart failure hospitalization and atrial fibrillationhard clinical
High cumulative ventricular pacing increases the risk of heart failure hospitalization and atrial fibrillation in patients with sinus node dysfunction and normal baseline QRS duration, regardless of AV synchrony preservation.
Cite This Study
Sweeney et al. (2003) studied this question.