The Clinical Implications of Cumulative Right Ventricular Pacing in the Multicenter Automatic Defibrillator Trial II
Why the study?
Does frequent right ventricular pacing increase the risk of heart failure and ventricular arrhythmias in patients with ICDs?
Population
567 patients with implantable cardioverter defibrillators from the Multicenter Automatic Defibrillator…
Comparison
Frequent right ventricular pacing vs Infrequent right ventricular pacing
Design
Cohort
Authors
Discussion
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Member takes
Implication
May warrant minimizing RV pacing in ICD patients; observational data leaves open causality and need for randomized confirmation.
Structured PICO
Does frequent right ventricular pacing increase the risk of heart failure and ventricular arrhythmias in patients with ICDs?
P
Population
567 patients with implantable cardioverter defibrillators (ICDs) from the Multicenter Automatic Defibrillator Implantation Trial (MADIT) II
I
Intervention
Frequent right ventricular pacing (51-100% of cumulative pacing, median pacing rate 95.6%)
C
Comparator
Infrequent right ventricular pacing (0-50% of cumulative pacing, median pacing rate 0.2%)
O
Outcome
New or worsening heart failure, appropriate ICD therapy for VT/VF, and the combined endpoint of heart failure or deathcomposite
Frequent right ventricular pacing in ICD patients is associated with an increased risk of new or worsening heart failure and ventricular arrhythmias, highlighting the deleterious effects of RV pacing in severe LV dysfunction.
Cite This Study
Steinberg et al. (2005) studied this question.