Effects of enhanced pacing modalities on health care resource utilization and costs in bradycardia patients: An analysis of the randomized MINERVA trial

Premature Trigger of ERI in Medtronic EnRhythm Devices

“…1,2 The clinical utility of this technology was recently evaluated and confirmed in the MiNimizE Right Ventricular pacing to prevent atrial fibrillation and heart failure (MINERVA) study. [3][4][5] This large study demonstrated in more than 1,100 patients MVP with the use of atrial preventive pacing was a superior setting to dual-chamber pacing in the primary end point of death and cardiac hospitalization. It also demonstrated a significant reduction in the progression of these patients to permanent atrial fibrillation.…”

“…This large study demonstrated in more than 1,100 patients MVP with the use of atrial preventive pacing was a superior setting to dual‐chamber pacing in the primary end point of death and cardiac hospitalization. It also demonstrated a significant reduction in the progression of these patients to permanent atrial fibrillation . However, despite these benefits, the end‐of‐life behavior of this device model was unpredictable.…”

“…The Medtronic EnRhythm (Medtronic Inc., Minneapolis, MN, USA) device was developed with some unique pacing options with the advent of managed ventricular pacing (MVP) to reduce the burden of ventricular pacing and also the ability to deliver antitachycardia pacing (ATP) within the atria to treat atrial arrhythmias . The clinical utility of this technology was recently evaluated and confirmed in the MiNimizE Right Ventricular pacing to prevent atrial fibrillation and heart failure (MINERVA) study . This large study demonstrated in more than 1,100 patients MVP with the use of atrial preventive pacing was a superior setting to dual‐chamber pacing in the primary end point of death and cardiac hospitalization.…”

“…It also demonstrated a significant reduction in the progression of these patients to permanent atrial fibrillation. 4 However, despite these benefits, the end-of-life behavior of this device model was unpredictable. In February 2010, Medtronic reported a small percentage of EnRhythm devices reaching premature unanticipated elective replacement indicator (ERI) during device interrogation, rendering the device to a nonprogrammable asynchronous mode that could only be resolved by device replacement.…”

Reactive atrial‐based antitachycardia pacing therapy reduces atrial tachyarrhythmias

“…In addition, use of rATP reduced early recurrence of AF and was associated with more frequent positive atrial remodeling (>10% reduction in left atrial diameter) . AF‐related hospitalization, AF‐related emergency department visits, and cardioversions were also significantly reduced . However, MINERVA's population was limited to pacemaker recipients without complete atrioventricular block.…”