Key result
Optimized PVAB cuts inappropriate mode switch from far-field R-wave sensing by ~62% vs standard programming.
Why the study?
Far-field R wave sensing in the atrial channel of dual chamber pacemakers causes inappropriate mode switch, leading to hemodynamic disadvantage and arrhythmias, and strategies to avoid this are needed.
Does individually optimized postventricular atrial blanking period reduce inappropriate mode switch due to far-field R wave sensing in patients with dual chamber pacemakers?
Population
207 patients with dual chamber pacemakers for sinus nodal disease, AV block, binodal disease, or other indications
Comparison
Individually optimized PVAB vs standard nominal PVAB of 100 msec
Design
Randomized controlled trial
Follow-up
3 months
Authors
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Supports individualized postventricular atrial blanking in dual-chamber pacemakers; provides RCT confirmation for far-field sensing mitigation.
RCT (n=207)
Does individually optimized postventricular atrial blanking period reduce inappropriate mode switch due to far-field R wave sensing in patients with dual chamber pacemakers?
Absolute Event Rate: 10% vs 26%
p-value: p=<0.01
Individual adjustment of the postventricular atrial blanking period significantly reduces the incidence of inappropriate mode switch due to far-field R wave sensing in dual chamber pacemakers.
Kolb et al. (2006) conducted an RCT in Patients requiring a dual chamber pacemaker (n=207). Individually optimized postventricular atrial blanking period (PVAB) vs. Standard programming of the PVAB (nominal 100 msec) was evaluated on Occurrence of inappropriate mode switch due to far-field R wave sensing within 3 months after pacemaker implantation (p=<0.01). Individually optimized postventricular atrial blanking period reduced inappropriate mode switch due to far-field R wave sensing compared to standard programming (10% vs 26%; P<0.01).
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