Arrhythmias & electrophysiology
Systematic review and meta-analysis on the impact on outcomes of device algorithms for minimizing right ventricular pacing
Authors' conclusion
Algorithms for RVPm may be effective in reducing the risk of PerAF and CV hospitalization in patients requiring anti-bradycardia therapies, without an increased risk of adverse symptoms.
Study context
- Population
- Patients requiring anti-bradycardia therapies
- Participants
- 7,229 patients8 studies
- Comparison
- RVPm algorithms vs DDD pacing
- Outcome
- Persistent/permanent AF (persistent/permanent atrial fibrillation (PerAF)), cardiovascular (CV) hospitalization, all-cause death and adverse symptoms (predefined endpoints)
Pooled result
As reported in the abstract
PerAF, CV hospitalization, all-cause death, adverse symptoms
RVPm vs DDDOdds ratio (95% CI)
PerAF
0.74(0.57–0.97)
CV hospitalization
0.77(0.61–0.97)
- No significant difference in all-cause death
- OR 1.01, 95% CI 0.78-1.30
- No significant difference in adverse symptoms
- OR 1.03, 95% CI 0.81-1.29
Further pooled results
Pooled mean
| Outcome | RVPm | DDD |
|---|---|---|
| RV pacing percentage | 7.96% (95% CI 3.13–20.25) | 45.11% (95% CI 26.64–76.38) |
Studies enrolling a high percentage of atrioventricular block (AVB) patients (subgroup)
- No significant interaction between RVPm strategy and high-AVB studies
Safety
- No significant difference in adverse symptoms
- OR 1.03, 95% CI 0.81-1.29
Original publication
Systematic review and meta-analysis on the impact on outcomes of device algorithms for minimizing right ventricular pacing. Europace. Published 9 August 2024. doi:10.
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