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Abnormal Conduction Increases Risk of Adverse Outcomes From Right Ventricular Pacing

John J. Hayes, MD, FACC^_*,2, Arjun D. Sharma, MD, FACC, John C. Love, MD, FACC, John M. Herre, MD, FACC, Anna O. Leonen, MS^||, Peter J. Kudenchuk, MD, FACC^||,1 for the DAVID Investigators

^_* Marshfield Clinic and Research Foundation, Marshfield, Wisconsin
Regional Cardiology Associates, Sacramento, California
Maine Medical Center, Portland, Maine
Sentara Norfolk General Hospital, Norfolk, Virginia
^|| University of Washington, Seattle, Washington

View larger version (17K): [in a new window]   Figure 1 Kaplan-Meier curve depicting the primary end point of death or first hospitalization for new or worsening heart failure in patients with normal conduction who were programmed in a manner that did (DDDR-70) or did not (VVI-40) promote ventricular pacing. p = 0.94.

View larger version (18K): [in a new window]   Figure 2 Kaplan-Meier curve depicting the primary end point of death or first hospitalization for new or worsening heart failure in patients with normal QRS (<110 ms) (NQRS) or abnormal QRS (110 ms) (AbQRS) conduction who were programmed to pace infrequently (VVI-40) (p = 0.59).

View larger version (19K): [in a new window]   Figure 3 Kaplan-Meier curve depicting the primary end point of death or first hospitalization for new or worsening heart failure in patients with abnormal conduction who were programmed in a manner that did (DDDR-70) or did not (VVI-40) promote ventricular pacing. p = 0.01.

View larger version (12K): [in a new window]   Figure 4 Kaplan-Meier curve depicting the primary end point of death or first hospitalization for new or worsening heart failure in patients with abnormal conduction due to right bundle branch block (RBBB) (A), a nonspecific conduction abnormality (IVCD) (B), or left bundle branch block (LBBB) (C) who were programmed in a manner that did (DDDR-70) or did not (VVI-40) promote ventricular pacing. Statistical significance for an adverse outcome associated with ventricular pacing (DDDR-70) was observed only in patients with LBBB (p = 0.03).