Atrial overdriving is beneficial in patients with atrial arrhythmias: First results of the PROVE study

The AF Prevention by Overdriving (PROVE) trial is an ongoing prospective st udy of the effectiveness of atrial overdrive pacing combined with an Automa tic Rest Rate function in the prevention of atrial arrhythmias. All patient s who have received a Talent DR 213 pacemaker are eligible for enrollment i nto the study. After a 1-month monitoring period, the patients are divided into two groups. Group I includes patients with greater than or equal to 2 appropriate mode-switch (MS) episodes, or 1 MS episode of greater than or e qual to 10 minutes, and/or > 300 atrial runs of > 5 beats/month. Group II i ncludes all other patients. The number and duration of atrial arrhythmias a re measured the pacemaker's Automatic interpretation and Data Analysis soft ware (AIDA). Patients' quality-of-life is measured by a validated functiona l status questionnaire. After having been grouped, the patients are randoml y assigned, in a crossover design, to standard DDDR or overdrive pacing + R est Rate, each programmed for a 3-month period. Preliminary results in 78 p atients show a 34% reduction in the mean number of MS, and a mean 48% short ening of the overall duration of the episodes by overdrive pacing + Rest Ra te, achieved by a mean 84% prevalence of atrial pacing. Overdrive pacing Rest Rate was well tolerated and associated with a slight improvement in qu ality-of-life.