{"id":"840dd5a235ea","type":"article","url":"https://hartvaat.nl/2024/08/03/device-algoritmen-voor-rv-pacingminimalisatie-meta-analyse-van-uitkomsten/","title":"Device-algoritmen voor RV-pacingminimalisatie: meta-analyse van uitkomsten","title_en":"Systematic review and meta-analysis on the impact on outcomes of device algorithms for minimizing right ventricular pacing.","category":"atriumfibrilleren","category_label":"Atriumfibrilleren","professions":["cardioloog"],"tags":[],"journal":"Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology","doi":"10.1093/europace/euae212","source_url":"https://doi.org/10.1093/europace/euae212","authors":["Davide Antonio Mei","Jacopo Francesco Imberti","Marco Vitolo","Niccolò Bonini","Kevin Serafini","Marta Mantovani","Enrico Tartaglia","Chiara Birtolo","Marco Zuin","Matteo Bertini","Giuseppe Boriani"],"significance":6,"published":"2024-08-03","source_date":"2024-08-03","image":"","kennis":[],"congress":"","summary_en":"This meta-analysis showed that device algorithms minimizing right ventricular pacing improve clinical outcomes including reduced AF and heart failure, supporting the programming of RV pacing avoidance modes in pacemaker patients.","created":"2026-07-03T10:31:05Z","updated":"2026-07-03T13:30:07Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Meta-analyse toonde dat device-algoritmen voor minimalisatie van RV-pacing de uitkomsten verbeteren, met minder AF en hartfalen. Programmeerstrategieën die onnodige pacing vermijden zijn klinisch waardevol.","abstract_original":"AIMS: Physiological activation of the heart using algorithms to minimize right ventricular pacing (RVPm) may be an effective strategy to reduce adverse events in patients requiring anti-bradycardia therapies. This systematic review and meta-analysis aimed to evaluate current evidence on clinical outcomes for patients treated with RVPm algorithms compared to dual-chamber pacing (DDD). METHODS AND RESULTS: We conducted a systematic search of the PubMed database. The predefined endpoints were the occurrence of persistent/permanent atrial fibrillation (PerAF), cardiovascular (CV) hospitalization, all-cause death, and adverse symptoms. We also aimed to explore the differential effects of algorithms in studies enrolling a high percentage of atrioventricular block (AVB) patients. Eight studies (7229 patients) were included in the analysis. Compared to DDD pacing, patients using RVPm algorithms showed a lower risk of PerAF [odds ratio (OR) 0.74, 95% confidence interval (CI) 0.57-0.97] and CV hospitalization (OR 0.77, 95% CI 0.61-0.97). No significant difference was found for all-cause death (OR 1.01, 95% CI 0.78-1.30) or adverse symptoms (OR 1.03, 95% CI 0.81-1.29). No significant interaction was found between the use of the RVPm strategy and studies enrolling a high percentage of AVB patients. The pooled mean RVP percentage for RVPm algorithms was 7.96% (95% CI 3.13-20.25), as compared with 45.11% (95% CI 26.64-76.38) of DDD pacing. CONCLUSION: Algorithms for RVPm may be effective in reducing the risk of PerAF and CV hospitalization in patients requiring anti-bradycardia therapies, without an increased risk of adverse symptoms. These results are also consistent for studies enrolling a high percentage of AVB patients."}