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 .
Minimizing ventricular pacing to reduce atrial fibrillation in sinus-node disease.
BACKGROUND Conventional dual-chamber pacing maintains atrioventricular synchrony but results in high percentages of ventricular pacing , which causes ventricular desynchronization and has been linked to an increased risk of atrial fibrillation in patients with sinus-node disease . METHODS We r and omly assigned 1065 patients with sinus-node disease , intact atrioventricular conduction , and a normal QRS interval to receive  conventional dual-chamber pacing ( 535 patients ) or dual-chamber minimal ventricular pacing with the use of new pacemaker features design ed to promote atrioventricular conduction , preserve ventricular conduction , and prevent ventricular desynchronization ( 530 patients ) . The primary end point was time to persistent atrial fibrillation . RESULTS The mean ( + /-SD ) follow-up period was 1.7+/-1.0 years when the trial was stopped because it had met the primary end point . The median percentage of ventricular beats that were paced was lower in dual-chamber minimal ventricular pacing than in conventional dual-chamber pacing ( 9.1 % vs. 99.0 % , P<0.001 ) , whereas the percentage of atrial beats that were paced was similar in the two groups ( 71.4 % vs. 70.4 % , P=0.96 ) . Persistent atrial fibrillation developed in 110 patients , 68 ( 12.7 % ) in the group assigned to conventional dual-chamber pacing and 42 ( 7.9 % ) in the group assigned to dual-chamber minimal ventricular pacing . The hazard ratio for development of persistent atrial fibrillation in patients with dual-chamber minimal ventricular pacing as compared with those with conventional dual-chamber pacing was 0.60 ( 95 % confidence interval , 0.41 to 0.88 ; P=0.009 ) , indicating a 40 % reduction in relative risk . The absolute reduction in risk was 4.8 % . The mortality rate was similar in the two groups ( 4.9 % in the group receiving dual-chamber minimal ventricular pacing vs. 5.4 % in the group receiving conventional dual-chamber pacing , P=0.54 ) . CONCLUSIONS Dual-chamber minimal ventricular pacing , as compared with conventional dual-chamber pacing , prevents ventricular desynchronization and moderately reduces the risk of persistent atrial fibrillation in patients with sinus-node disease . ( Clinical Trials.gov number , NCT00284830 [ Clinical Trials.gov ] . )
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 .