Mode Selection Trial (MOST)

Adverse effect of ventricular pacing on heart failure and atrial fibrillation among patients with normal baseline QRS duration in a clinical trial of pacemaker therapy for sinus node dysfunction

Sweeney MO, Hellkamp AS, Ellenbogen KA, et al, for the MOde Selection Trial (MOST) Investigators.
Circulation. 2003;107:2932-2937.

1,339 patients from the Mode Selection Trial (MOST), a 6-year, prospective, randomized study, received either dual-chamber pacing (DDDR) or single-chamber ventricular pacing (VVIR) in sinus node dysfunction (SND). Ventricular desynchronization, imposed by ventricular pacing even when AV synchrony was preserved, increased the risk of heart failure hospitalization and atrial fibrillation in SND with normal baseline QRSd.

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