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This Week in JAMA
December 25, 2002

This Week in JAMA

JAMA. 2002;288(24):3077. doi:10.1001/jama.288.24.3077

Most currently implanted implantable cardioverter defibrillator (ICD) devices are coupled with dual-chamber pacemaker devices. The Dual Chamber and VVI Implantable Defibrillator (DAVID) trialArticle compared the efficacy of dual-chamber pacing with that of ventricular backup pacing in patients with left ventricular dysfunction and indications for ICD implantation for the treatment of ventricular tachyarrhythmias but without an indication for antibradycardia pacing. At 1 year, the rate of the composite end point of death or first hospitalization for new or worsened congestive heart failure was significantly higher in patients who received dual-chamber rate-responsive pacing at 70/min than among those who received ventricular backup pacing at 40/min. In an editorial, KassArticle discusses the adverse effect of discoordinated ventricular activity from single-site ventricular stimulation.