Evidence map›Paper›PMID 26206737›Full record

Trial reportJournal of the American Heart Association2015

Very Low Ventricular Pacing Rates Can Be Achieved Safely in a Heterogeneous Pacemaker Population and Provide Clinical Benefits: The CANadian Multi-Centre Randomised Study-Spontaneous AtrioVEntricular Conduction pReservation (CAN-SAVE R) Trial.

Bernard Thibault, Anique Ducharme, Adrian Baranchuk, Marc Dubuc, Katia Dyrda, Peter G Guerra, Laurent Macle, Blandine Mondésert, Léna Rivard, Denis Roy and 5 more

Registry-linked trialOpen access · goldAbstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Journal of the American Heart Association, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01219621 (A Prospective Canadian Multi-Center Randomized Study; Spontaneous AtrioVEntricular Conduction PReservation), which is not on this map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
0.8field-weighted citation impact, top 23% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01219621 phase3completednot on this map

A Prospective Canadian Multi-Center Randomized Study; Spontaneous AtrioVEntricular Conduction PReservation

TypeinterventionalSponsorSorin Group CanadaRan2006 to 2009Enrolled450ConditionsAny Patient Who Fulfills the Inclusion Criteria to be Implanted With a Dual Chamber Pacemaker Maybe Included in the Study as Per ACC/AHA GuidelinesArmsSymphony Dual Chamber Rate Responsive Device
3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.

  1. Systematic review and meta-analysis on the impact on outcomes of device algorithms for minimizing right ventricular pacing.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024
    Pooled it
  2. Article
  3. Article
  4. Avoiding unnecessary ventricular pacing is associated with reduced incidence of heart failure hospitalizations and persistent atrial fibrillation in pacemaker patients.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023
    Observational
  5. 2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2022
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 3 institutions in 1 country.

Bernard ThibaultMontreal Heart Institute and Université de Montréal, Montreal, Quebec, Canada (B.T., A.D., M.D., K.D., P.G.G., L.M., B.M., R., D.R., M.T., J.A., P.K.).
Anique DucharmeMontreal Heart Institute and Université de Montréal, Montreal, Quebec, Canada (B.T., A.D., M.D., K.D., P.G.G., L.M., B.M., R., D.R., M.T., J.A., P.K.).
Adrian BaranchukKingston General Hospital, Kingston, Ontario, Canada (A.B.).
Marc DubucMontreal Heart Institute and Université de Montréal, Montreal, Quebec, Canada (B.T., A.D., M.D., K.D., P.G.G., L.M., B.M., R., D.R., M.T., J.A., P.K.).
Katia DyrdaMontreal Heart Institute and Université de Montréal, Montreal, Quebec, Canada (B.T., A.D., M.D., K.D., P.G.G., L.M., B.M., R., D.R., M.T., J.A., P.K.).
Peter G GuerraMontreal Heart Institute and Université de Montréal, Montreal, Quebec, Canada (B.T., A.D., M.D., K.D., P.G.G., L.M., B.M., R., D.R., M.T., J.A., P.K.).
Laurent MacleMontreal Heart Institute and Université de Montréal, Montreal, Quebec, Canada (B.T., A.D., M.D., K.D., P.G.G., L.M., B.M., R., D.R., M.T., J.A., P.K.).
Blandine MondésertMontreal Heart Institute and Université de Montréal, Montreal, Quebec, Canada (B.T., A.D., M.D., K.D., P.G.G., L.M., B.M., R., D.R., M.T., J.A., P.K.).
Léna RivardMontreal Heart Institute and Université de Montréal, Montreal, Quebec, Canada (B.T., A.D., M.D., K.D., P.G.G., L.M., B.M., R., D.R., M.T., J.A., P.K.).
Denis RoyMontreal Heart Institute and Université de Montréal, Montreal, Quebec, Canada (B.T., A.D., M.D., K.D., P.G.G., L.M., B.M., R., D.R., M.T., J.A., P.K.).
Mario TalajicMontreal Heart Institute and Université de Montréal, Montreal, Quebec, Canada (B.T., A.D., M.D., K.D., P.G.G., L.M., B.M., R., D.R., M.T., J.A., P.K.).
Jason AndradeMontreal Heart Institute and Université de Montréal, Montreal, Quebec, Canada (B.T., A.D., M.D., K.D., P.G.G., L.M., B.M., R., D.R., M.T., J.A., P.K.).
Rémi NitzschéSORIN Group CRM, Montreal, Quebec, Canada (N.).
Paul KhairyMontreal Heart Institute and Université de Montréal, Montreal, Quebec, Canada (B.T., A.D., M.D., K.D., P.G.G., L.M., B.M., R., D.R., M.T., J.A., P.K.).
CAN‐SAVE R Study Investigators
Université de Montréal · CAMontreal Heart Institute · CAKingston General Hospital · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIt is well recognized that right ventricular apical pacing can have deleterious effects on ventricular function. We performed a head-to-head comparison of the SafeR pacing algorithm versus DDD pacing with a long atrioventricular delay in a heterogeneous population of patients with dual-chamber pacemakers. METHODS AND

resultsIn a multicenter prospective double-blinded randomized trial conducted at 10 centers in Canada, 373 patients, age 71±11 years, with indications for dual chamber DC pacemakers were randomized 1:1 to SafeR or DDD pacing with a long atrioventricular delay (250 ms). The primary objective was twofold: (1) reduction in the proportion of ventricular paced beats at 1 year; and (2) impact on atrial fibrillation burden at 3 years, defined as the ratio between cumulative duration of mode-switches divided by follow-up time. Statistical significance of both co-primary end points was required for the trial to be considered positive. At 1 year of follow-up, the median proportion of ventricular-paced beats was 4.0% with DDD versus 0% with SafeR (P<0.001). At 3 years of follow-up, the atrial fibrillation burden was not significantly reduced with SafeR versus DDD (median 0.00%, interquartile range [0.00% to 0.23%] versus median 0.01%, interquartile range [0.00% to 0.44%], respectively, P=0.178]), despite a persistent reduction in the median proportion of ventricular-paced beats (10% with DDD compared to 0% with SafeR).

conclusionsA ventricular-paced rate <1% was safely achieved with SafeR in a population with a wide spectrum of indications for dual-chamber pacing. However, the lower percentage of ventricular pacing did not translate into a significant reduction in atrial fibrillation burden. CLINICAL

trial registrationURL: https://www.clinicaltrials.gov/ Unique identifier: NCT01219621.

Indexed as

Cardiac Resynchronization Therapy DevicesVentricular Function, LeftVentricular Function, RightAction PotentialsAgedAged, 80 and overAlgorithmsArrhythmias, CardiacAtrial FibrillationAtrioventricular NodeCanadaCardiac Resynchronization TherapyDouble-Blind MethodEquipment DesignFemaleHeart Rateadverse arrhythmic eventsatrial fibrillationdual‐chamber pacemakerlong atrioventricular delayright ventricular pacing

Identifiers

PMID26206737
PMCPMC4608083
OpenAlexW2137369542

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.