Minimizing ventricular pacing to reduce atrial fibrillation in sinus-node disease

Michael O. Sweeney, Alan J. Bank, Emmanuel Nsah, Maria Koullick, Qian Cathy Zeng, Douglas Hettrick, Todd Sheldon, Gervasio A. Lamas

Research output: Contribution to journalArticlepeer-review

341 Scopus citations


Background: Conventional dual-chamber pacing maintains atrioventricular synchrony but results in high percentages of ventricular pacing, which causes ventricular desynchronization and has been linked to an increased risk of atrial fibrillation in patients with sinus-node disease. Methods: We randomly assigned 1065 patients with sinus-node disease, intact atrioventricular conduction, and a normal QRS interval to receive conventional dual-chamber pacing (535 patients) or dual-chamber minimal ventricular pacing with the use of new pacemaker features designed to promote atrioventricular conduction, preserve ventricular conduction, and prevent ventricular desynchronization (530 patients). The primary end point was time to persistent atrial fibrillation. Results: The mean (±SD) follow-up period was 1.7±1.0 years when the trial was stopped because it had met the primary end point. The median percentage of ventricular beats that were paced was lower in dual-chamber minimal ventricular pacing than in conventional dual-chamber pacing (9.1% vs. 99.0%, P

Original languageEnglish (US)
Pages (from-to)1000-1008
Number of pages9
JournalNew England Journal of Medicine
Issue number10
StatePublished - Sep 6 2007
Externally publishedYes

ASJC Scopus subject areas

  • Medicine(all)


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