# Device-algoritmen voor RV-pacingminimalisatie: meta-analyse van uitkomsten

*geplaatst 2024-08-03 · Atriumfibrilleren · 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 · https://hartvaat.nl/2024/08/03/device-algoritmen-voor-rv-pacingminimalisatie-meta-analyse-van-uitkomsten/*

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.

## English: Systematic review and meta-analysis on the impact on outcomes of device algorithms for minimizing right ventricular pacing.

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.

## Abstract (original, from the publication)

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.

Auteurs: Davide Antonio Mei, Jacopo Francesco Imberti, Marco Vitolo, Niccolò Bonini, Kevin Serafini, Marta Mantovani, Enrico Tartaglia, Chiara Birtolo, Marco Zuin, Matteo Bertini, Giuseppe Boriani

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Bron: 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, https://doi.org/10.1093/europace/euae212. Bijgewerkt 2026-07-03T13:30:07Z. 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.