Are plasma natriuretic peptide levels influenced by automatic pacemaker algorithms for ventricular pacing minimization?

Kreuzer, Joerg; Lennerz, Carsten; Dietl, Josef U; Beier, Thomas; Strauch, Alexej; Semmler, Verena; Badran, Haitham; Zrenner, Bernhard; Kolb, Christof

doi:10.1111/pace.12070

journal article

Document type:: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
Author(s):: Kreuzer, Joerg; Lennerz, Carsten; Dietl, Josef U; Beier, Thomas; Strauch, Alexej; Semmler, Verena; Badran, Haitham; Zrenner, Bernhard; Kolb, Christof
Title:: Are plasma natriuretic peptide levels influenced by automatic pacemaker algorithms for ventricular pacing minimization?
Abstract:: Automatic atrioventricular search hysteresis (AVSH) is designed to reduce the cumulative percentage of potentially deleterious right ventricular apical pacing (VP%) in dual-chamber pacemakers. We investigated whether minimizing VP% by AVSH can, in turn, reduce ventricular wall stretching/stress, as assessed by plasma concentrations of the amino-terminal fragment of the pro-B-type natriuretic peptide (NT-proBNP).After dual-chamber pacemaker implantation in 81 patients (age: 69 ± 11 years; males: 55.6%), the fixed atrioventricular delay of 225 ms was programmed and AVSH was turned off for 1 month. The patients were thereafter randomly assigned to standard AVSH for 1 month, followed by an enhanced AVSH for another month, or vice versa. At the 1-, 2-, and 3-month follow-ups, VP% values were retrieved from the pacemaker memory, and venous blood samples were taken for NT-proBNP measurements.Both standard and enhanced AVSH reduced the median VP% value from 38.5% (for the fixed atrioventricular delay) to 2.1% (P < 0.001). However, plasma NT-proBNP concentrations for the fixed atrioventricular delay (median, 253 pg/mL), standard AVSH (225 pg/mL), and enhanced AVSH (276 pg/mL) did not differ significantly on the intrapatient basis (paired Wilcoxon tests) between any pair of these modalities.Minimizing ventricular pacing by AVSH during 1 month had no influence on plasma NT-proBNP levels (i.e., ventricular wall stretching/stress) compared with a constant, moderately prolonged atrioventricular delay.
Journal title abbreviation:: Pacing Clin Electrophysiol
Year:: 2013
Journal volume:: 36
Journal issue:: 4
Pages contribution:: 424-32
Language:: eng
Fulltext / DOI:: doi:10.1111/pace.12070
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/23305402
Print-ISSN:: 0147-8389
TUM Institution:: Klinik für Herz- und Kreislauferkrankungen im Erwachsenenalter (Prof. Schunkert)
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mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Lehr- und Forschungskooperationen mit den Kliniken und Instituten am Deutschen Herzzentrum Klinik für Herz- und Kreislauferkrankungen im Erwachsenenalter (DHM) (Prof. Schunkert)2013