Key result
Programming the MVP function [On] significantly reduced median atrial arrhythmia burden at 10 months compared to [off] (1% vs 22%; P<0.001) and decreased ventricular pacing.
Why the study?
Does the Manage Ventricular Pacing (MVP) algorithm reduce ventricular pacing burden and atrial arrhythmias in patients with dual-chamber pacemakers for SND or AVB?
Observational (n=220)
Yes
Does the Manage Ventricular Pacing (MVP) algorithm reduce ventricular pacing burden and atrial arrhythmias in patients with dual-chamber pacemakers for SND or AVB?
Absolute Event Rate: 1% vs 22%
p-value: p=<0.001
Programming the MVP algorithm on in dual-chamber pacemakers significantly reduces unnecessary ventricular pacing and atrial arrhythmia burden in patients with sinus node dysfunction or atrio-ventricular block.
MVP activation may lower atrial arrhythmia burden in dual-chamber pacemakers; leaves open confirmation in randomized SND/AVB trials.
BACKGROUND: Using dual-chamber pacemakers with new algorithms: Manage Ventricular Pacing (MVP™), minimizes unnecessary ventricular pacing (VP). This function operates in AAI/R mode with backup VP during AV block. AIM: The aim of "Generation MVP" study was to assess the VP burden and atrial arrhythmias (AA) burden according to indication of pacing and MVP™ function programming of AdaptaDR implantable pacemaker (Medtronic Inc., Minneapolis, MN, USA). METHODS: The multicenter observational "Generation MVP" study included 220 patients aged 75.9 ± 11 years (men = 52%) implanted for sinus node dysfunction (SND; n = 115) or atrio-ventricular block (AVB; n = 105). Programming MVP function has been left to the physician's discretion. Percentage of VP and AA burden (percentage of time spent in AA) stored in memories were assessed at 2 and 10 months. RESULTS: 220 patients were followed at 2 months (174 MVP [On], 46 MVP [off]) and at 10 months (165 MVP [On], 55 MVP [off]). Median percentage of VP is significantly lower when MVP is programmed [On] versus [off] at 2 and 10 months follow-up for SND and AVB indications of pacing (P < 0.001). Finally, programming MVP function is performed at middle term (10 months) for 84% of patients with SND and 65% of patients with AVB: median percentage of VP is as low as 0.6% for patients with SND and 12% for patients with AVB versus 95% for SND and 99% for AVB when MVP function is programmed [off](P < 0.001). Median AA burden was significantly lower when MVP function was programmed [On] versus [off] at 2 months (8.7% vs 28%; P < 0.001) and 10 months (1% vs 22%; P < 0.001). CONCLUSION: In this study programming MVP function decreases percentage of VP at 2 and 10 months for patients paced for SND or AVB. Moreover median AA burden is reduced when MVP function was programmed [On] vs [off] at two follow-ups.
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Rey et al. (2012) conducted an observational in Sinus node dysfunction or atrio-ventricular block (n=220). Manage Ventricular Pacing (MVP) function programmed [On] vs. MVP function programmed [off] was evaluated on Median atrial arrhythmias (AA) burden at 10 months (p=<0.001). Programming the MVP function [On] significantly reduced median atrial arrhythmia burden at 10 months compared to [off] (1% vs 22%; P<0.001) and decreased ventricular pacing.
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