Prevention of long‐lasting atrial fibrillation through antitachycardia pacing in DDDR pacemakers
Key result
Reactive ATP is linked to a ~53% lower incidence of persistent AF versus DDDR pacing.
- P=0.012
- n=146
Why the study?
It was unclear whether Reactive ATP alone, independent of preventive pacing, is the main driver of persistent or permanent AF reduction observed with DDDRP pacing in pacemaker patients with an AF history.
Does Reactive ATP without preventive pacing reduce the incidence of persistent AF in dual-chamber pacemaker patients with a history of AF?
Population
146 consecutive dual-chamber pacemaker patients with AF history across 31 centres
Comparison
Reactive ATP without preventive pacing vs MINERVA trial groups (Control DDDR, MVP, DDDRP)
Design
Multicentre comparative non-randomised study
Follow-up
Median 31 months
Authors
Discussion
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Implication
Reactive ATP alone may reduce persistent AF incidence in pacemaker patients; leaves open confirmation versus full algorithm combinations in randomized trials.
Study Design
Type
Observational (n=146)
Multicenter
Yes
Structured PICO
Does Reactive ATP without preventive pacing reduce the incidence of persistent AF in dual-chamber pacemaker patients with a history of AF?
P
Population
146 dual-chamber pacemaker patients with a history of atrial fibrillation (mean age 73, 46% female) followed for a median of 31 months.
E
Exposure
Reactive ATP (antitachycardia pacing) programmed without preventive atrial pacing.
C
Comparator
Three groups from the MINERVA randomized trial (Control DDDR, MVP, and DDDRP).
O
Outcome
Incidence of AF longer than 7 consecutive days.surrogate
Main Result
Absolute Event Rate: 12% vs 25.8%
p-value: p=0.012
Reactive ATP alone is associated with a low incidence of persistent AF in pacemaker patients, suggesting it is the primary driver of the benefits observed in the MINERVA trial.
Cite This Study
Boriani et al. (2020) conducted an observational in Atrial fibrillation (n=146). Reactive ATP vs. Standard DDDR pacing (MINERVA Control DDDR arm) was evaluated on Incidence of AF longer than 7 consecutive days (p=0.012). Reactive ATP programming in pacemaker patients with atrial fibrillation history was associated with a lower 2-year incidence of persistent AF compared to standard DDDR pacing (12% vs 25.8%, P=0.012).