Impact of AV conduction disorders on SafeR mode performance

Area of Science:

• Cardiology
• Biomedical Engineering
• Medical Devices

Background:

• Pacemaker technology aims to optimize cardiac rhythm management.
• Minimizing right ventricular (V) pacing is a key goal to improve patient outcomes.
• Current pacing modes, like DDD with a long atrioventricular (AV) delay, have limitations.

Purpose of the Study:

• To evaluate a novel pacing mode algorithm designed to minimize V pacing in pacemaker (PM) recipients.
• To compare this new algorithm against the standard DDD mode with a long AV delay.
• To assess the preliminary safety and efficacy of the new pacing mode.

Main Methods:

• The CAN-SAVE R study is a Canadian multicenter trial.
• 208 patients were enrolled, excluding those with permanent atrial fibrillation or high-degree AV block.
• Preliminary data were collected over a 2-month baseline period with the new pacing mode.

Main Results:

• The overall median V pacing was less than 1% (mean 9.5%).
• Patients without AV block showed minimal V pacing (0.5% median).
• Two adverse events potentially related to the new mode occurred in patients with AV block.

Conclusions:

• The new pacing mode is effective and safe for general PM recipients without permanent AV block.
• The algorithm significantly reduces V pacing, achieving a median of <1%.
• Long-term effects on clinical outcomes and cardiac function will be assessed in the ongoing CAN-SAVE R trial.