Individualized selection of pacing algorithms for the prevention of recurrent atrial fibrillation: Results from the VIP registry

Pacing and Clinical Electrophysiology : PACE
T LewalterBerndt Lüderitz

Abstract

The VIP registry investigated the efficacy of preventive pacing algorithm selection in reducing atrial fibrillation (AF) burden. There are few data identifying which patients might benefit most from which preventive pacing algorithms. Patients, with at least one documented AF episode and a conventional antibradycardia indication for pacemaker therapy, were enrolled. They received pacemakers with AF diagnostics and four preventive algorithms (Selection and PreventAF series, Vitatron). A 3-month Diagnostic Phase with conventional pacing identified a Substrate Group (>70% of AF episodes with <2 premature atrial contractions [PACs] before AF onset) and a Trigger Group (< or =70% of AF episodes with <2 PACs before AF onset). This was followed by a 3-month Therapeutic Phase where in the Trigger Group algorithms were enabled aimed at avoiding or preventing a PAC and in the Substrate Group continuous atrial overdrive pacing was enabled. One hundred and twenty-six patients were evaluated. In the Trigger Group (n = 73), there was a statistically significant 28% improvement in AF burden (median AF burden: 2.06 hours/day, Diagnostic Phase vs 1.49 hours/day, Therapy Phase; P = 0.03304 signed-rank test), and reduced PAC activity. There was n...Continue Reading

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