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- Title
Atrial overdrive pacing and incidence of heart failure-related adverse events in permanently paced patients.
- Authors
Andreas Schuchert; Mark Carlson; John Ip; John Messenger; Scott Beau; Steven Kalbfleisch; Pierre Gervais; Douglas Cameron; Aurelio Duran; Jesus Val-Mejias; Judith Mackall; Michael Gold
- Abstract
Abstract Background  Atrial overdrive pacing algorithms may be effective in preventing or suppressing atrial fibrillation (AF). However, the maintenance of a heart rate incessantly faster than spontaneous could induce left ventricular (LV) dysfunction and promote heart failure (HF) on the long term. Objective  This post hoc analysis examined the effects of a new overdrive algorithm on the incidence of HF-related adverse events in 411 patients enrolled in the ADOPT-A trial. Materials and methods  The AF Suppression⢠algorithm was randomly programmed ON in 209 patients (treatment group) versus OFF in 202 patients (control group). The incidence of HF-related adverse events and HF-related deaths over a 6-month follow-up was compared between the two groups. Patients with versus without HF-related clinical events were also compared to each other within each group. Results  There were eight HF-related adverse clinical events (3.8%) in the treatment group and 11 (5.4%) in the control group, including four HF-related deaths (1.9 vs. 2.0%) in each group during follow-up. Baseline NYHA functional class in patients with versus without HF-related adverse events was 1.4â�â0.5 versus 1.5â�â0.7 in the control, and 1.5â�â0.8 versus 1.5â�â0.6 in the treatment group. LV ejection fraction (EF) was 49â�â7% in patients with, versus 57â�â12% in patients without HF-related adverse events, in the control group, and 43â�â14% in patients with, versus 56â�â13% in patients without HF-related adverse events, in the treatment group. LVEF was lowest and similar in both groups among patients who died from HF (35â�â10% in the control and 38â�â27% in the treatment group). Conclusions  In ADOPT-A, HF-related clinical events and deaths were related to LV dysfunction and not to atrial pacing overdriven by the AF suppression algorithm.
- Subjects
ATRIAL fibrillation; HEART failure; CARDIAC patients; CARDIAC pacing
- Publication
Journal of Interventional Cardiac Electrophysiology, 2007, Vol 19, Issue 1, p55
- ISSN
1383-875X
- Publication type
Article