Single lead atrial vs. dual chamber pacing in sick sinus syndrome: extended register-based follow-up in the DANPACE trial
Key result
Single lead atrial pacing showed no significant difference in long-term mortality compared to dual chamber pacing in patients with sick sinus syndrome (HR 1.03; 95% CI 0.90-1.19; P=0.65).
Why the study?
Does single lead atrial (AAIR) pacing compared to dual chamber (DDDR) pacing reduce mortality in patients with sick sinus syndrome?
Population
1,384 patients with sick sinus syndrome (SSS) included at Danish pacemaker centers in the DANPACE trial
Comparison
Single lead atrial (AAIR) pacemaker vs Dual chamber (DDDR) pacemaker
Design
Cohort, Randomized to AAIR (n = 696) or DDDR (n = 688)
Follow-up
mean 8.9 years
Authors
Discussion
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Overview
No long-term mortality difference seen between AAIR and DDDR in SSS; extends DANPACE but leaves mode selection open pending randomized data on AF and reoperation.
Study Design
Type
RCT (n=1,384)
Randomization
randomized
Multicenter
Yes
Structured PICO
Does single lead atrial (AAIR) pacing compared to dual chamber (DDDR) pacing reduce mortality in patients with sick sinus syndrome?
P
Population
1,384 patients with sick sinus syndrome randomized to single lead atrial or dual chamber pacemaker, followed for a mean of 8.9 years.
I
Intervention
Single lead atrial (AAIR) pacemaker
C
Comparator
Dual chamber (DDDR) pacemaker
O
Outcome
Death (mortality) at very long-term follow-uphard clinical
Main Result
Hazard Ratio: 1.03 (95% CI 0.9–1.19)
Absolute Event Rate: 59.3% vs 53.3%
p-value: p=0.65
Extended register-based follow-up of the DANPACE trial confirms no significant difference in long-term mortality, stroke, or heart failure between single-lead atrial and dual-chamber pacing in patients with sick sinus syndrome.
Cite This Study
Brandt et al. (2016) conducted an RCT in Sick sinus syndrome (SSS) (n=1,384). Single lead atrial (AAIR) pacemaker vs. Dual chamber (DDDR) pacemaker was evaluated on Death (adjusted HR 1.03, 95% CI 0.90-1.19, p=0.65). Single lead atrial pacing showed no significant difference in long-term mortality compared to dual chamber pacing in patients with sick sinus syndrome (HR 1.03; 95% CI 0.90-1.19; P=0.65).