Asymptomatic Atrial Fibrillation and Stroke Evaluation in Pacemaker Patients and the Atrial Fibrillation Reduction Atrial Pacing Trial
To evaluate the hypothesis among patients with a standard indication for pacing and no previous history of AF, detection of AHRE predicts an increased risk of stroke and systemic embolism. The second hypothesis to be tested is that overdrive atrial pacing with the AF suppression algorithm will reduce the risk of symptomatic AF in patients with standard indication for pacing and no previous history of AF.
Randomized, multicenter, cohort follow-up, and single-blinded trial of atrial overdrive pacing in elderly hypertensive patients with a pacemaker recently implanted for sinus or atrioventricular (AV) node disease.
Primary Outcomes: Asymptomatic AF Stroke Evaluation, first occurance of either component of the composite of 1. Ischemic Stroke 2. Non-CNS systemic embolism. Trial of AF Suppression Algorithm, Symptomatic or asymptomatic atrial tachyarrhythmia (>6mins) documented by 12 lead ECG, or surface ECG rhythm strip. Secondary Outcomes: 1. Symptomatic atrial tachyarrhythmia (>6mins) documented by 12 lead ECG, or surface ECG rhythm strip. 2. Symptomatic or asymptomatic atrial tachyarrhythmia (>6mins) documented by 12 lead ECG, surface ECG rhythm strip or pacemaker telemetry (EGMs only). 3. Total cardiovascular events (composite of stroke, myocardial infarction, vascular death, systemic embolism or admission to hospital for heart failure). 4. AF Burden as derived from the pacemaker telemetry. 5. Major bleed.
Stuart Connolly, Jeff Healey
St. Jude Medical