9-03: Aair vs. dddr in sick sinus syndrome. extended follow-up in danpace
Bibliographic record
Abstract
Purpose: The Danish Multicenter Randomized Trial on Single Lead Atrial vs. Dual Chamber Pacing in Sick Sinus Syndrome (DANPACE) trial included 1415 patients with symptomatic sick sinus syndrome (SSS). After a mean follow-up of 5.4 years, this trial showed no differences in overall survival, stroke or heart failure (HF), whereas the risks of atrial fibrillation (AF) and pacemaker reoperation were significantly increased in patients randomized to AAI-pacing. The present study investigated long-term risk of death, stroke, HF, AF and PM-reoperation using national registry-based data. Method: The study population consisted of all 1384 patients included at Danish pacemaker centers in the DANPACE trial, 31 patients randomized in United Kingdom and Canada were excluded. Long-term follow-up data were obtained from the Danish National Health Registry, the Danish Pacemaker Registry and the Danish Civil Registry to extend the original DANPACE trial-database. Cox proportional-hazards regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between randomized pacing mode and long-term survival, AF, HF, stroke and pacemaker reoperation adjusted for a priori selected confounders. Data analysis was intention-to-treat. Summary: The population consisted of 696 AAI- and 688 DDD-patients (97.8% of the DANPACE cohort). Median follow-up was 9.25 years (5-95 percentiles: 1.4-15.3 years). No patients were lost to follow-up. During follow-up 413 patients (59.3%) died in the AAI-group compared to 368 (53.5%) in the DDD-group; (adjusted HR (aHR) 1.04; confidence interval (CI) 0.90-1.19; p = 0.61). AF requiring hospitalization occurred in 211 patients (30.3%) in the AAI-group vs. 211 (30.7%) in DDD-group (aHR 0.99; CI 0.82-1.20; p = 0.94). There were no differences in risk of stroke (AAI 14.7% vs DDD 14.4%; aHR 0.99; CI 0.75-1.31; p = 0.95) or HF-hospitalization (AAI 13.9% vs DDD 13.7%; aHR 0.98; CI 0.73-1.30; p = 0.86). Four hundreds and fourteen patients (59.5%) had one or more reoperations in the AAI-group compared to 340 patients (49.4%) in the DDD-group (aHR 1.63; CI 1.42-1.88; p < 0.001). Predictors associated with increased risk of reoperation were randomization to AAI-PM and hypertension (HR 1.20; CI 1.03-1.41; p = 0.023). Conclusion: Using national registry-based data, this study supports previous findings of no significant difference in all-cause mortality among patients with sick sinus syndrome randomized to AAI- or DDD-PM. A significantly higher risk of reoperation was observed in patients randomized to AAI-pacing. We identified no differences in risk of hospitalization for AF, stroke or HF.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".