PEGASUS CRT: Atrial support pacing safe in patients with HF

No differences in mortality or HF events were reported using three different atrial pacing settings.

Patients with HF who receive a cardiac resynchronization device and atrial support pacing were not adversely affected, according to study results presented Friday at Heart Rhythm 2009 in Boston.

Researchers for the PEGASUS-CRT enrolled 1,433 patients with HF and randomly assigned them at 1:1:1 to receive atrial support pacing programmed at either the DDD-40 setting (n=379), the DDD-70 setting (n=393) or DDDR-40 setting (n=391). The DDD-40 group was the control group, and the primary composite endpoint consisted of all-cause mortality, HF events, NYHA functional class and patient global self-assessment.

The researchers reported no differences in the composite endpoint between any of the three treatment arms. According to the study results, 27% of patients in the DDD-70 group worsened, compared with 30% in the control group and 28% in the DDDR-40 group. The proportion of patients whose condition remained unchanged was 21% in the DDD-70 group compared with 18% in the control group and 19% in the DDDR-40 group. Improvement was reported in 52% of patients in the DDD-70 group (P=.60 for all values vs. control) and the control group, and in 53% of the patients in the DDDR-40 group (P=.59 for all values vs. control). The researchers also reported no differences between treatment groups for mortality or HF events.

“These data suggest that providing atrial support pacing by programming a higher lower rate limit or rate-adaptive pacing appears to safe,” David O. Martin, MD,an electrophysiologist at the Cleveland Clinic in Ohio, said in his presentation. “Atrial support pacing did not adversely impact outcomes and is not associated with differences in death or HF events.” – by Eric Raible

For more information:

Martin D. LBCT II. Presented at: Heart Rhythm 2009; May 13-16, 2009; Boston.

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