June 27, 2006Circulation
Cardiovascular Outcomes With Atrial-Based Pacing Compared With Ventricular Pacing
Why the study?
Does atrial-based pacing reduce major cardiovascular events (mortality, stroke, heart failure, atrial fibrillation) compared to ventricular pacing in patients with bradycardia?
Population
Patients with bradycardia from 8 randomized trials
Comparison
Atrial-based pacing (dual-chamber or atrial) vs Ventricular-based pacing
Design
Meta-analysis
Follow-up
35,000 patient-years total
Authors
Discussion
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Member takes
Implication
Supports atrial-based over ventricular pacing in bradycardia to cut AF and stroke; confirms no mortality or HF benefit in pooled data.
Structured PICO
Does atrial-based pacing reduce major cardiovascular events (mortality, stroke, heart failure, atrial fibrillation) compared to ventricular pacing in patients with bradycardia?
P
Population
Patients with bradycardia from 8 randomized trials (individual patient data from 5 trials representing 95% of patients)
I
Intervention
Atrial-based pacing (dual-chamber or atrial)
C
Comparator
Ventricular-based pacing
O
Outcome
Mortality, stroke, heart failure, or atrial fibrillationhard clinical
Atrial-based pacing reduces the incidence of atrial fibrillation and may modestly reduce stroke compared to ventricular pacing, but does not improve survival or reduce heart failure.
Cite This Study
Healey et al. (2006) studied this question.