Key result
Algorithms for minimizing ventricular pacing significantly reduced the incidence of atrial fibrillation compared to conventional pacing protocols (OR 0.74; 95% CI 0.55-1.00; P<0.05).
Why the study?
Right ventricular pacing increases the risk of AF, but whether algorithms for minimizing ventricular pacing reduce AF incidence remains controversial.
Do algorithms for minimizing ventricular pacing reduce the incidence of atrial fibrillation in patients with pacemakers implanted?
Meta-Analysis (n=5,705)
Do algorithms for minimizing ventricular pacing reduce the incidence of atrial fibrillation in patients with pacemakers implanted?
The use of algorithms to minimize ventricular pacing in patients with pacemakers reduces the incidence of atrial fibrillation by 26% compared to conventional pacing.
Answers are grounded in this paper and cite their sources.
Supports use of ventricular pacing minimization algorithms to reduce atrial fibrillation in pacemaker patients; confirms benefit in this meta-analysis of trials.
Background: Right ventricular pacing disrupts atrioventricular synchrony and increases the risk of atrial fibrillation (AF). However, whether algorithms for minimizing ventricular pacing reduce the incidence of AF remains controversial. Therefore, we conducted a systematic review and meta-analysis to compare the incidence of AF between minimizing ventricular pacing and conventional pacing protocols in patients with pacemakers implanted. Methods: The PubMed, Embase, and Cochrane Library databases were searched up to August 1, 2017, for randomized controlled trials that reported the incidence of AF in patients with and without the use of algorithms for minimizing ventricular pacing. Results: Eleven studies comprising 5705 participants (61% males, mean age 71 years [standard deviation 11 years]) were finally included in the analysis. The mean follow-up duration was 24 months. Use of algorithms for minimizing ventricular pacing significantly reduced the incidence of AF, with an odds ratio of 0.74 (95% confidence interval 0.55–1.00; P<0.05). There was moderate heterogeneity among studies (I 2=63%). Conclusions: The incidence of AF was reduced by 26% with use of algorithms for minimizing ventricular pacing. The incorporation of such algorithms in routine clinical practice should in theory lead to a decrease in AF-related morbidity and mortality.
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Lakhani et al. (2020) conducted a meta-analysis in Patients with pacemakers implanted (n=5,705). Algorithms for minimizing ventricular pacing vs. Conventional pacing protocols was evaluated on Incidence of atrial fibrillation (OR 0.74, 95% CI 0.55-1.00, p=<0.05). Algorithms for minimizing ventricular pacing significantly reduced the incidence of atrial fibrillation compared to conventional pacing protocols (OR 0.74; 95% CI 0.55-1.00; P<0.05).
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