The importance of avoiding unnecessary right ventricular pacing in clinical practice

Table 3 Clinical studies of pacemaker algorithms that minimize right ventricular pacing

Study	Design	Pacing	Patients	Follow-up	Outcomes
		indication	(n)	(mo)
Sweeney et al[30]	Randomized, crossover MVP vs DDD(R)	SSS	181	1	Amount of pacing: MVP™: 4.1%; DDD(R): 73.8%
Murakami et al[29]	Randomized, crossover MVP vs Search AV+	SSS and AVB	127	1	Amount of pacing: MVP: 66.1%; Search AV+: 54.3% (patients with %RVP < 40) MVP: 57.5%; Search AV+: 38.6% (patients with %RVP < 10)
Olshansky et al[32]	RCT DDD(R) AVSH 60/min vs VVI 40/min (non-inferiority)	ICD1	1530	10.4	Trend towards a lower rate of death and hospitalization for HF in the DDD(R) AVSH group
Sweeney et al[33]	RCT Search AV+/MVP vs DDD(R)	SSS	1065	12	Amount of pacing: DDD(R): 99%; Search AV+/MVP: 9.1% Reduction in time to development of AF (primary endpoint) in the search AV+/MVP group No difference in hospitalization for HF or death (secondary endpoints)
Sweeney et al[36]	RCT MVP 60/min vs VVI 40/min (non-inferiority)	ICD1	1030	29	Prematurely interrupted due slightly more deaths and hospitalization for HF in MVP group

¹Patients with an implantable cardiac defibrillator indication were included in the trial; AVB: Atrioventricular block; AVSH: AV Search Hysteresis (Medtronic); MVP: Managed Ventricular Pacing (Medtronic, Minneapolis, MS, United States); ICD: Implantable cardiac defibrillator; RCT: Randomized control trial; RVP: Right ventricular pacing; SSS: Sick sinus syndrome; VVI: Ventricular.