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February 1, 1993HeartOpen Access

Mean peak heart rate was higher in AAIR mode (130 vs 122, p<0.02), but exercise time (12.3 vs 12.3 minutes, NS) and arrhythmia frequency showed no significant differences compared to AAI mode.

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Why the study?

Does adaptive rate atrial (AAIR) pacing improve maximal exercise capacity and suppress arrhythmias compared to fixed rate atrial (AAI) pacing in patients with sick sinus syndrome?

Population

30 consecutive patients with sick sinus syndrome requiring permanent pacing, without evidence of conduction…

Comparison

Adaptive rate atrial pacing using activity… vs Fixed rate atrial (AAI) pacing

Design

RCT, randomised, crossover, single blind

Authors

GHGuy A. HaywoodDKDemosthenes G. KatritsisJWJoseph Ward

Discussion

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Overview

AAIR pacing does not improve exercise capacity or reduce arrhythmias versus AAI despite higher peak heart rate; challenges routine use of rate-adaptive atrial pacing in sick sinus syndrome.

Structured PICO

Does adaptive rate atrial (AAIR) pacing improve maximal exercise capacity and suppress arrhythmias compared to fixed rate atrial (AAI) pacing in patients with sick sinus syndrome?

P
Population
30 consecutive patients (mean age 65) with sick sinus syndrome requiring permanent pacing, without evidence of conduction disturbance on 12 lead ECG or 24 hour ambulatory ECG monitoring and without other cardiovascular or systemic disease.
I
Intervention
Adaptive rate atrial (AAIR) pacing using activity sensing or minute ventilation driven systems
C
Comparator
Fixed rate atrial (AAI) pacing
O
Outcome
Maximal exercise capacity (measured by treadmill exercise testing) and frequency of supraventricular and ventricular arrhythmias (measured by 24 hour ambulatory electrocardiographic monitoring)surrogate

In patients with sick sinus syndrome, adaptive rate atrial pacing increases peak heart rate but does not improve exercise capacity or reduce arrhythmias compared to fixed rate pacing.

Cite This Study

Haywood et al. (1993) studied this question.

synapsesocial.com/papers/6a7059046ceb2bbd16dfdccbhttps://doi.org/10.1136/hrt.69.2.174
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Rate adaptive pacing in sick sinus syndrome: effects of pacing modes and intrinsic conduction on physiological responses, arrhythmias, symptomatology and quality of life1994 · 23 citations
  2. 2Lack of Physiological Adaptation of the Atrioventricular Interval to Heart Rate in Patients Chronically Paced in the AAIR Mode1991 · 39 citations
  3. 3AAIR Versus DDDR Pacing in Patients with Impaired Sinus Node Chronotropy: An Echocardiographic and Cardiopulmonary Study1997 · 27 citations
  4. 4Respiratory‐Dependent Atrial Pacing, Management of Sinus Node Disease1988 · 22 citations
  5. 5Atrial rate-responsive pacing in sinus node disease1990 · 30 citations