Arrhythmias & electrophysiologyMeta-analysis
Systematic review and meta-analysis on the impact on outcomes of device algorithms for minimizing right ventricular pacing
- Systematic review and meta-analysis
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 patients · 8 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
Adverse symptoms
- 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:10.1093/europace/euae212
Summarised from the published abstract; every number is checked against it