MINERVA trial: DDDR versus DDDRP-MVP in patients with bradycardia

The sinus node disease is approximately 50 % of pacemaker implants. Atrial fibrillation is a frequent comorbidity of pacemakers and is associated with heart failure, stroke and death.

While unnecessary stimulation of the right ventricle has a long term detrimental effect, including an increased risk of atrial fibrillation. In the ventricular pacing mode (MVP, managed ventricular pacing) stimulation occurs in both chambers, reducing unnecessary right ventricular pacing only.

The study included patients with class I or II indication for dual-chamber pacemakers and prior atrial tachycardia but no history of permanent atrial fibrillation or AV block grade 3. At follow-up there was no difference in mortality or rehospitalization but a lower incidence of permanent atrial fibrillation (61% reduction in the group DDDRP versus DDDR ) .

 Conclusion:

In patients with symptomatic bradycardia pacing modality DDDRP + MVP pacemaker, proved superior to the dual chamber pacing.

4_giuseppe_boriani
Giuseppe Boriani
2013-11-18

Original title: Atrial Antitachycardia Pacing and Managed Ventricular Pacing Reduce the Endpoint Composed by Death, Cardiovascular Hospitalizations and Permanent Atrial Fibrillation Compared to Conventional Dual Chamber Pacing in Bradycardia Patients: Results of the Minerva Randomized Study.

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