A comparison of single-lead atrial pacing with dual-chamber pacing in XXXX .

@entity1 @entity64 @entity712 @entity1817 @entity955 @entity204 @entity1168
AIMS: In @entity1 with @entity1817 , @entity1168 can be treated with a single-lead pacemaker or a dual-chamber pacemaker. Previous trials have revealed that pacing modes preserving atrio-ventricular synchrony are superior to single-lead ventricular pacing, but it remains unclear if there is any difference between single-lead atrial pacing (AAIR) and dual-chamber pacing (DDDR). METHODS AND RESULTS: We randomly assigned 1415 @entity1 referred for first pacemaker implantation to AAIR (n = 707) or DDDR (n = 708) pacing and followed them for a mean of 5.4    2.6 years. The primary outcome was @entity204 from any cause. Secondary outcomes included paroxysmal and chronic @entity955 , @entity64 , @entity712 , and need for pacemaker reoperation. In the AAIR group, 209 @entity1 (29.6%) died during follow-up vs. 193 @entity1 (27.3%) in the DDDR group, hazard ratio (HR) 1.06, 95% confidence interval (CI) 0.88-1.29, P = 0.53. @entity955 was observed in 201 @entity1 (28.4%) in the AAIR group vs. 163 @entity1 (23.0%) in the DDDR group, HR 1.27, 95% CI 1.03-1.56, P = 0.024. A total of 240 @entity1 underwent one or more pacemaker reoperations during follow-up, 156 (22.1%) in the AAIR group vs. 84 (11.9%) in the DDDR group (HR 1.99, 95% CI 1.53-2.59, P < 0.001). The incidence of chronic @entity955 , @entity64 , and @entity712 did not differ between treatment groups. CONCLUSION: In @entity1 with @entity1817 , there is no statistically significant difference in @entity204 from any cause between AAIR pacing and DDDR pacing. AAIR pacing is associated with a higher incidence of @entity955 and a two-fold increased risk of pacemaker reoperation. These findings support the routine use of DDDR pacing in these @entity1 . CLINICAL TRIAL REGISTRATION: URL http://www.clinicaltrials.gov. Unique identifier: NCT00236158.
