October 13, 2009Pacing and Clinical Electrophysiology
Impact of Right Ventricular Pacing Sites on Exercise Capacity during Ventricular Rate Regularization in Patients with Permanent Atrial Fibrillation
Key result
Ventricular rate regularization pacing improved exercise capacity (exercise time, METs, and VO2max) during exercise in patients with right ventricular septal pacing, but not apical pacing (P<0.05).
Why the study?
Does ventricular rate regularization improve exercise capacity in patients with permanent atrial fibrillation depending on the right ventricular pacing site?
Population
30 patients with permanent atrial fibrillation and symptomatic bradycardia who received pacemaker…
Comparison
VVI-mode with ventricular rate regularization… vs VVI-mode during acute cardiopulmonary exercise…
Design
Cohort
Follow-up
Acute (during exercise testing)
Authors
Discussion
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Member takes
Implication
May support VR regularization with septal RV pacing in permanent AF; leaves open randomized confirmation of clinical benefit.
Structured PICO
Does ventricular rate regularization improve exercise capacity in patients with permanent atrial fibrillation depending on the right ventricular pacing site?
P
Population
30 patients with permanent atrial fibrillation and symptomatic bradycardia who received pacemaker implantation with right ventricular apical or septal pacing.
I
Intervention
VVI-mode with ventricular rate regularization (VRR) algorithm on (VVI-ON) during acute cardiopulmonary exercise testing
C
Comparator
VVI-mode (VVI-OFF) during acute cardiopulmonary exercise testing
O
Outcome
Exercise capacity (measured by exercise time, metabolic equivalents [METs], and peak oxygen consumption [VO2max])surrogate
Main Result
p-value: p=<0.05
Ventricular rate regularization improves exercise capacity in patients with permanent atrial fibrillation only when pacing is performed at the right ventricular septum, rather than the apex.
Cite This Study
Tse et al. (2009) studied Permanent atrial fibrillation and symptomatic bradycardia (n=30). Ventricular rate regularization (VRR) algorithm (VVI-ON) vs. VVI-mode without VRR (VVI-OFF) was evaluated on Exercise capacity (peak exercise VR, exercise time, METs, peak VO2, VR variability) (p=<0.05). Ventricular rate regularization pacing improved exercise capacity (exercise time, METs, and VO2max) during exercise in patients with right ventricular septal pacing, but not apical pacing (P<0.05).