Why Is It Critical to Pace Less?

Reducing unnecessary ventricular pacing has been shown to improve clinical outcomes by reducing the risks of atrial fibrillation (AF)^1-4 and heart failure hospitalization (HFH).^1,4

There is a 1% increase in the risk of AF for each 1% increase in cumulative right ventricular pacing.⁴

RV pacing > 40% of the time in DDDR mode was associated with a 2.6-fold increased risk of HFH compared with pacing < 40%.⁴

References

1. Anderson HR, Nielsen JC, Thomsen PEB, et al. Long-term follow-up of patients from a randomised trial of atrial versus ventricular pacing for sick-sinus syndrome. Lancet. 1997;350:1210-1216.
2. Skanes AC, Krahn AD, Yee R, et al, for the CTOPP Investigators. Progression to chronic atrial fibrillation after pacing: The Canadian Trial Of Physiologic Pacing. J Am Coll Cardiol. 2001;38:167-172.
3. Neilsen J, Kristensen L, Andersen H, et al. A randomized comparison of atrial and dual chamber pacing in 177 consecutive patients with sick sinus syndrome. J Am Col Cardiol. 2003;42:614-623.
4. Sweeney M, Hellkamp A, Ellenbogen K, et al. 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. Circulation. 2003;107:2932-2937.

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