Jongmin Hwang MD, Seongwook Han MD, Hyoung-Seob Park MD, Tae-Wan Chung MD, Minsu Jung MD, Seung-Jung Park MD, Chan-Hee Lee MD, Jin Hee Ahn MD, Eue-Keun Choi MD, Myung Hwan Bae MD, Young Soo Lee MD, Sang Won Park MD, Dae In Lee MD, Yoo-Ri Kim MD, Min-Soo Ahn MD, Jaemin Shim MD
{"title":"评估双腔起搏器的心室起搏抑制算法：LEADER \"研究结果","authors":"Jongmin Hwang MD, Seongwook Han MD, Hyoung-Seob Park MD, Tae-Wan Chung MD, Minsu Jung MD, Seung-Jung Park MD, Chan-Hee Lee MD, Jin Hee Ahn MD, Eue-Keun Choi MD, Myung Hwan Bae MD, Young Soo Lee MD, Sang Won Park MD, Dae In Lee MD, Yoo-Ri Kim MD, Min-Soo Ahn MD, Jaemin Shim MD","doi":"10.1002/joa3.13117","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>There is limited research on the intra-individual efficacy of ventricular pacing minimization algorithms developed by Biotronik—the Ventricular Pace Suppression algorithm (VpS) and the Intrinsic Rhythm Support plus algorithm (IRSplus) (BIOTRONIK SE & Co. KG, Berlin, Germany). We performed a randomized pilot trial that evaluated the efficacy of two algorithms in patients with symptomatic sinus node dysfunction (SND) who received a dual-chamber pacemaker.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>The trial was conducted in 11 tertiary hospitals in South Korea. The patients were randomized to either the VpS or IRSplus algorithm group after a 3-month period of fixed atrioventricular (AV) delay. The primary outcome was the ventricular pacing percentage (Vp%) at each follow-up visit. The secondary outcomes were the occurrence of heart failure (HF) and atrial fibrillation (AF) during the study period.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Data from 131 patients were analyzed. Initially, their average Vp% over 3 months with a fixed AV interval was 14.1 ± 19.4%. Patients were randomly assigned to VpS and IRSplus groups, with 66 and 65 in each. Algorithms reduced average Vp% to 4.0 ± 11.3% at 9 months and 6.7 ± 14.9% at 15 months. These algorithms were more effective for patients with paced AV delay (PAVD) ≤300 ms compared to those with PAVD >300 ms. Both algorithms were equally effective in reducing Vp%. Clinical AF or HF hospitalization was not observed during the study period.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>The VpS and IRSplus algorithms are effective and safe in minimizing unnecessary ventricular pacing in patients with SND.</p>\n </section>\n </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"40 4","pages":"965-974"},"PeriodicalIF":2.2000,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.13117","citationCount":"0","resultStr":"{\"title\":\"Evaluation of ventricular pacing suppression algorithms in dual chamber pacemaker: Results of “LEADER” study\",\"authors\":\"Jongmin Hwang MD, Seongwook Han MD, Hyoung-Seob Park MD, Tae-Wan Chung MD, Minsu Jung MD, Seung-Jung Park MD, Chan-Hee Lee MD, Jin Hee Ahn MD, Eue-Keun Choi MD, Myung Hwan Bae MD, Young Soo Lee MD, Sang Won Park MD, Dae In Lee MD, Yoo-Ri Kim MD, Min-Soo Ahn MD, Jaemin Shim MD\",\"doi\":\"10.1002/joa3.13117\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>There is limited research on the intra-individual efficacy of ventricular pacing minimization algorithms developed by Biotronik—the Ventricular Pace Suppression algorithm (VpS) and the Intrinsic Rhythm Support plus algorithm (IRSplus) (BIOTRONIK SE & Co. KG, Berlin, Germany). We performed a randomized pilot trial that evaluated the efficacy of two algorithms in patients with symptomatic sinus node dysfunction (SND) who received a dual-chamber pacemaker.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>The trial was conducted in 11 tertiary hospitals in South Korea. The patients were randomized to either the VpS or IRSplus algorithm group after a 3-month period of fixed atrioventricular (AV) delay. The primary outcome was the ventricular pacing percentage (Vp%) at each follow-up visit. The secondary outcomes were the occurrence of heart failure (HF) and atrial fibrillation (AF) during the study period.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Data from 131 patients were analyzed. Initially, their average Vp% over 3 months with a fixed AV interval was 14.1 ± 19.4%. Patients were randomly assigned to VpS and IRSplus groups, with 66 and 65 in each. 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Evaluation of ventricular pacing suppression algorithms in dual chamber pacemaker: Results of “LEADER” study
Background
There is limited research on the intra-individual efficacy of ventricular pacing minimization algorithms developed by Biotronik—the Ventricular Pace Suppression algorithm (VpS) and the Intrinsic Rhythm Support plus algorithm (IRSplus) (BIOTRONIK SE & Co. KG, Berlin, Germany). We performed a randomized pilot trial that evaluated the efficacy of two algorithms in patients with symptomatic sinus node dysfunction (SND) who received a dual-chamber pacemaker.
Methods
The trial was conducted in 11 tertiary hospitals in South Korea. The patients were randomized to either the VpS or IRSplus algorithm group after a 3-month period of fixed atrioventricular (AV) delay. The primary outcome was the ventricular pacing percentage (Vp%) at each follow-up visit. The secondary outcomes were the occurrence of heart failure (HF) and atrial fibrillation (AF) during the study period.
Results
Data from 131 patients were analyzed. Initially, their average Vp% over 3 months with a fixed AV interval was 14.1 ± 19.4%. Patients were randomly assigned to VpS and IRSplus groups, with 66 and 65 in each. Algorithms reduced average Vp% to 4.0 ± 11.3% at 9 months and 6.7 ± 14.9% at 15 months. These algorithms were more effective for patients with paced AV delay (PAVD) ≤300 ms compared to those with PAVD >300 ms. Both algorithms were equally effective in reducing Vp%. Clinical AF or HF hospitalization was not observed during the study period.
Conclusion
The VpS and IRSplus algorithms are effective and safe in minimizing unnecessary ventricular pacing in patients with SND.
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