Statistical heterogeneity between included studies was not detected ( chi(2 ) = 1.68 , P = 0.43 , I(2 ) = 0 % ) , although significant clinical differences were found in terms of study design , patient population s , statins use and dosage and AF-monitoring capabilities .
Statins may represent a novel treatment strategy to prevent the occurrence of AF in patients with PM , especially for those who had a PM implanted due to sinus node dysfunction .
Patients with permanent pacemakers ( PM ) are at high risk of developing atrial fibrillation ( AF ) .
Minimal ventricular pacing modalities have been demonstrated to reduce AF in such patients , although they are not suitable for patients with advanced atrioventricular conduction disease .
Recent evidence s suggest that 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors ( i.e. statins ) may represent a new strategy to prevent AF in patients at risk .
In this article , we sought to review data regarding the effectiveness of statin therapy in preventing AF patients with a PM .
The acute effect of cardiac pacing mode on endothelial vasodilation: prospective, double-blind, cross-over, comparative clinical study.
BACKGROUND Compared to atrioventricular sequential pacing , ventricular dem and pacing is known to have somewhat more deleterious hemodynamic effects , which probably arise from increased sympathetic tonus and inappropriate baroreceptor activation . Endothelial function is affected by various local and systemic factors including baroreceptor activity . The aim of this study was to explore whether cardiac pacing would have any effect on endothelial functions . METHODS Twelve patients ( six male , mean age : 75 + /- 9 years ) with previously implanted DDD or VDDcardiac pacemakers were included . All patients had stable atrial rhythms during the study . Patients were r and omized to either atrial-based pacing mode ( VDD or DDD ) or ventricular dem and pacing mode ( VVI ) first , and then cross-over was performed with the other pacing mode . Endothelial function was assessed by brachial artery ultrasonography . Basal diameter of the brachial artery , and both flow-mediated dilation ( FMD ) and endothelium-independent vasodilation with nitroglycerin were measured 1 hour after each pacing mode . RESULTS Compared to atrial-based pacing mode , ventricular dem and pacing was associated with a significantly worse FMD both as absolute and percentage values ( 0.17 + /- 0.09 mm vs 0.28 + /- 0.11 mm , P = 0.015 and 4.84 + /- 2.37 % vs 7.00 + /- 2.88 % , P = 0.028 , respectively ) . However , there was no significant difference in nitroglycerin-mediated vasodilation values between the two pacing sessions . CONCLUSIONS Acute ventricular dem and pacing ( VVI pacing ) is clearly associated with attenuation of FMD in patients with atrial-based pacing systems . The attenuation of endothelial vasodilation might have a role in hemodynamic and clinical deterioration in patients with VVI pacemakers
Statistical heterogeneity between included studies was not detected ( chi(2 ) = 1.68 , P = 0.43 , I(2 ) = 0 % ) , although significant clinical differences were found in terms of study design , patient population s , statins use and dosage and AF-monitoring capabilities .
Statins may represent a novel treatment strategy to prevent the occurrence of AF in patients with PM , especially for those who had a PM implanted due to sinus node dysfunction .
Patients with permanent pacemakers ( PM ) are at high risk of developing atrial fibrillation ( AF ) .
Minimal ventricular pacing modalities have been demonstrated to reduce AF in such patients , although they are not suitable for patients with advanced atrioventricular conduction disease .
Recent evidence s suggest that 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors ( i.e. statins ) may represent a new strategy to prevent AF in patients at risk .
In this article , we sought to review data regarding the effectiveness of statin therapy in preventing AF patients with a PM .