OUP user menu

The OPTI-MIND study: a prospective, observational study of pacemaker patients according to pacing modality and primary indications

Mauro Biffi, Donato Melissano, Paolo Rossi, Gabriela Kaliska, Aleš Havlíĉek, Gemma Pelargonio, Rafael Romero, Ciro Guastaferro, Maurizio Menichelli, Elisa Vireca, Jessica Frisoni, Giuseppe Boriani, Tibor Malacký
DOI: http://dx.doi.org/10.1093/europace/eut387 689-697 First published online: 5 February 2014


Aims The OPTI-MIND study aims to collect 2-year clinical outcomes of pacemaker patients in real-world clinical practice, overall and according to patient characteristics and pacemaker settings.

Methods and results The present analysis of the OPTI-MIND study describes the programmed device settings after discharge from the pacemaker implant. The objective was to determine whether these settings fit recent guidelines for device-programmed physiological pacing based on the preservation of atrioventricular synchrony, avoiding unnecessary pacing, ensuring rate increase during exercise or preventing neurally mediated symptoms. A total of 1740 patients were enroled at 68 centres worldwide. Baseline patient characteristics and device programming settings are available in 1674 of 1740 patients (96%). Guidelines to ensure physiological pacing were followed in 41% of patients: in patients with sinus node disease (SND), and without atrioventricular block (AVB), device programming could have led to unnecessary right ventricular pacing in 38% of patients. In SND patients with chronotropic incompetence, assisted rate increase during exercise was not programmed in 42% of patients. In 11% of patients with AVB, atrioventricular (AV) synchrony was not pursued; the main drivers being advanced age and history of atrial fibrillation. Patients with both SND and AVB were generally programmed physiologically (87%).

Conclusion The present analysis showed that frequent deviations occurred when comparing the device settings at discharge from the pacemaker implant in clinical practice to the available guidelines on pacing mode selection. Analysis of 2-year outcomes in the OPTI-MIND study will provide an insight into whether specific physiological settings could improve the quality of pacing with a positive effect on patient outcome.

  • Bradyarrhythmia
  • Cardiac pacing
  • Pacemaker
  • Reprogramming
View Full Text

Sign in

ESC members If your subscription is provided via the European Society of Cardiology, either as a member or an ESC Congress delegate, select the 'ESC Member and Congress Delegate Sign In' link in the list below. Discover if you are an ESC member here. Note: after sign in you will be redirected to the journal's home page. 'ESC member' will display at the top of the page to indicate you have full access rights for this session.

Otherwise, if your subscription is via OUP, enter your OUP username and password, or select an alternative sign in option below.

List of OpenAthens registered sites, including contact details.