engleski

VVIR pacing versus DDDR pacing in patients with persistent atrial fibrillation after AV node ablation

Bacground. Both VVIR pacing and DDDR pacing may be implanted in patients (pts) with persistent atrial fibrillation (AF) after AV node ablation. However, it is still uknown which type of pacing offers greater benefit in this group of pts. Methods. Eighty six pts with persistent AF and AV node ablation were randomly assigned to VVIR or DDDR pacinmg. Pts in VVIR pacing group (n=44) received anticoagulant therapy. Pts in DDDR pacing group (n=42) received antiarrhythmic and anticoagulant drugs. The study end point was a composite of cardiovascular deaths, heart failure, thromboembolic complications, or severe adverse effect of antiarrhythmic drugs. Results. The baseline clinical data were similar among the two pacing groups. Sixty percent of pts had hypertension and 26% coronary artery disease. At a mean follow-up period of 21.6 months, the primary end point occurred in 14 pts (31.8%) in VVIR pacing grup and in 14 pts (33%) in DDDR pacing group. The distribution of the various components of the primary end point was similar in VVIR and DDDR pacing groups. Pts in DDDR pacing group had lower incidence of chronic AF than those in VVIR pacing group (23.8% versus 88%, P<0.001). Conclusion. VVIR pacing is not inferior to DDDR pacing for the prevention of death or morbidity due to cardiovascular causes in pts with persistent AF after AV node ablation, but results in higher development of chronic AF.

Persistent AF; AV node ablation; VVIR pacing; DDDR pacing

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