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Dokumenttyp:
journal article 
Autor(en):
Kolb, C; Schmidt, R; Dietl, JU; Weyerbrock, S; Morgenstern, M; Fleckenstein, M; Beier, T; Von Bary, C; Mackes, KG; Widmaier, J; Kreuzer, J; Semmler, V; Zrenner, B; PREVENT study group; Kolb, C; Schmidt, R; Zrenner, B; Deisenhofer, I; Semmler, V; Schömig, A; Dietl, JU; Sauer, E; Zrenner, B; Mühling, H; Weyerbrock, S; Morgenstern, M; Fleckenstein, M; Beier, T; Hagena, W; Maxrath, J; Hopperdietzel, W; Karch, MR; von Bary, C; Mackes, KG; Widmaier, J; Firschke, C; Hofbauer, F; Kreuzer, J; Strauch, A;...    »
 
Titel:
Reduction of right ventricular pacing with advanced atrioventricular search hysteresis: results of the PREVENT study. 
Abstract:
Right ventricular pacing predisposes to the development of heart failure and atrial fibrillation. Automatic atrioventricular search hysteresis (AVSH) is a commonly used strategy to decrease the percentage of right ventricular pacing (%VP) in patients without permanent AV block, but the results have not been optimal.The randomized, crossover PREVENT study evaluated whether an enhanced AVSH with two new features can reduce %VP compared with standard AVSH. The new features are the repetitive hysteresis [switch from extended to basic AV delay after a consistent loss of intrinsic AV conduction (IAVC) lasting for six consecutive atrial cycles] and the scan hysteresis (periodic IAVC search extension over six consecutive atrial cycles). Both standard AVSH and enhanced AVSH performed a periodic IAVC search every 180 cardiac cycles and operated with a basic AV-delay of 225 ms and a rate-independent maximum AV-delay of 300 ms for paced and sensed atrial events.Among 178 patients, 53.4% had no evidence of AV block at enrollment and 46.6% had history of intermittent AV block. The median %VP was decreased by enhanced AVSH compared to standard AVSH (4.0% vs 5.5%, P< 0.001), particularly in patients with a history of AV block (21.4% vs 25.5%, P< 0.001). The primary study hypothesis that 25% of all patients would experience> 20% relative %VP reduction was not met as 46 (25.8%) patients (95% confidence interval, 20.5-31.8%) presented such relative reduction.The enhanced AVSH algorithm reduces %VP compared with standard AVSH in patients with intermittent AV block. 
Zeitschriftentitel:
Pacing Clin Electrophysiol 
Jahr:
2011 
Band / Volume:
34 
Heft / Issue:
Seitenangaben Beitrag:
975-83 
Sprache:
eng 
Print-ISSN:
0147-8389 
TUM Einrichtung:
I. Medizinische Klinik und Poliklinik