Ventricular or Physiological Pacing to Prevent Stroke or Cardiovascular Death
Physiological pacing appears not to reduce significantly the annual rate of stroke or cardiovascular death compared with ventricular pacing. Level of evidence: "B"1 474 patients were randomly assigned to receive a ventricular pacemaker or a physiologic pacemaker 1. The annual rate of stroke or death due to cardiovascular causes was 5.5 percent with ventricular pacing compared with 4.9 percent with physiological pacing (reduction in relative risk, 9.4%, 95% CI -10.5 to 25.7).
Comment: The quality of evidence is downgraded by imprecise results (few patients and wide confidence intervals).
References
- Connolly SJ, Kerr CR, Gent M, Roberts RS, Yusuf S, Gillis AM, Sami MH, Talajic M, Tang AS, Klein GJ, Lau C, Newman DM. Effects of physiologic pacing versus ventricular pacing on the risk of stroke and death due to cardiovascular causes. Canadian Trial of Physiologic Pacing Investigators. N Engl J Med 2000 May 11;342(19):1385-91. [PubMed]