Arrhythmias & electrophysiologyRandomised controlled trial
Atrial pacing minimization in sinus node dysfunction and risk of incident atrial fibrillation: a randomized trial
- Randomised controlled trial
- nationwide
Authors' conclusion
Atrial pacing minimization in patients with sinus node dysfunction does not reduce the incidence of atrial fibrillation. Programming a base rate of 40 bpm without rate-adaptive pacing is associated with an increased risk of syncope or presyncope.
Study context
- Population
- Patients with sinus node dysfunction and an indication for first pacemaker implantation
- Participants
- 540 patients
- Comparison
- Atrial pacing minimization vs DDDR-60
- Primary endpoint
- Time to first episode of AF >6 min
- Follow-up
- 2 years
Primary result
First AF episode >6 min
Hazard ratio
0.97
95% CI 0.76–1.25
P = 0.83
Events by treatment group
DDD-40 vs DDDR-60
HR 0.97 (95% CI 0.76–1.25); P = 0.83
As reported in the abstract
Secondary outcomes
Median
| Outcome | DDDR-60 | DDD-40 |
|---|---|---|
| Atrial pacing percentage | 49% | 1% |
AF >6 h or >24 h, persistent AF, cardioversions for AF
- No between-group differences
Safety
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Syncope or presyncope · higher with DDD-40 | 1.71 (1.13–2.59) | P = 0.01 | |
| 0.20.5125Hazard ratio (log scale) |
Original publication
Atrial pacing minimization in sinus node dysfunction and risk of incident atrial fibrillation: a randomized trial. Eur Heart J. Published 28 August 2023. doi:10.1093/eurheartj/ehad564
Summarised from the published abstract; every number is checked against it