Please use this identifier to cite or link to this item:
https://hdl.handle.net/2440/121174
Citations | ||
Scopus | Web of Science® | Altmetric |
---|---|---|
?
|
?
|
Type: | Journal article |
Title: | Implication of ventricular pacing burden and atrial pacing therapies on the progression of atrial fibrillation: a systematic review and meta-analysis of randomized controlled trials |
Author: | Munawar, D.A. Mahajan, R. Agbaedeng, T.A. Thiyagarajah, A. Twomey, D.J. Khokhar, K. O'shea, C. Young, G.D. Roberts-Thomson, K.C. Munawar, M. Lau, D.H. Sanders, P. |
Citation: | Heart Rhythm, 2019; 16(8):1204-1214 |
Publisher: | Elsevier |
Issue Date: | 2019 |
ISSN: | 1547-5271 1556-3871 |
Statement of Responsibility: | Dian A. Munawar, Rajiv Mahajan, Thomas A. Agbaedeng, Anand Thiyagarajah, Darragh J. Twomey, Kashif Khokhar, Catherine O’Shea, Glenn D. Young, Kurt C. Roberts-Thomson, Muhammad Munawar, Dennis H.Lau, Prashanthan Sanders |
Abstract: | BACKGROUND:Atrial fibrillation (AF) is common after pacemaker implantation. However, the impact of pacemaker algorithms in AF prevention is not well understood. OBJECTIVE:The purpose of this study was to evaluate the role of pacing algorithms in preventing AF progression. METHODS:A systematic search of articles using the PubMed and Embase databases resulted in a total of 754 references. After exclusions, 21 randomized controlled trials (8336 patients) were analyzed, comprising studies reporting ventricular pacing percentage (VP%) (AAI vs DDD, n = 1; reducing ventricular pacing [RedVP] algorithms, n = 2); and atrial pacing therapies (atrial preference pacing [APP], n = 14; atrial antitachycardia pacing [aATP]+APP, n = 3; RedVP+APP+aATP, n = 1). RESULTS:Low VP% (<10%) lead to a nonsignificant reduction in the progression of AF (hazard ratio [HR] 0.80; 95% confidence interval [CI] 0.57-1.13; P = .21; I2 = 67%) compared to high VP% (>10%). APP algorithm reduced premature atrial complexes (PAC) burden (mean difference [MD] -1117.74; 95% CI -1852.36 to -383.11; P = .003; I2 = 67%) but did not decrease AF burden (MD 8.20; 95% CI -5.39 to 21.80; P = .24; I2 = 17%) or AF episodes (MD 0.00; 95% CI -0.24 to 0.25; P = .98; I2 = 0%). Similarly, aATP+APP programming showed no significant difference in AF progression (odds ratio 0.65; 95% CI 0.36-1.14; P = .13; I2 = 61%). No serious adverse events related to algorithm were reported. CONCLUSION:This meta-analysis of randomized controlled trials demonstrated that algorithms to reduce VP% can be considered safe. Low burden VP% did not significantly suppress AF progression. The atrial pacing therapy algorithms could suppress PAC burden but did not prevent AF progression. |
Keywords: | Arial preventive pacing Atrial fibrillation Atrial pacing therapies Minimize ventricular pacing Reduced ventricular pacing |
Rights: | Crown Copyright © 2019 Published by Elsevier Inc. on behalf ofHeart Rhythm Society. All rights reserved. |
DOI: | 10.1016/j.hrthm.2019.02.020 |
Grant ID: | NHMRC |
Published version: | http://dx.doi.org/10.1016/j.hrthm.2019.02.020 |
Appears in Collections: | Aurora harvest 8 Medicine publications |
Files in This Item:
There are no files associated with this item.
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.