6/28/23, 1:15 AM DAVID Pathway Feedback Search Clinical Topics Home Studies DAVID DAVID Disease Ventricular arrhythmias Trial question What is the role of dual-chamber pacing in patients with an indication for ICD? Study design Multi-center Single blinded RCT Population Characteristics of study participants 17.2% female N = 506 82.8% male 506 patients (88 female, 416 male) Inclusion criteria: patients with an indication for ICD Key exclusion criteria: permanent pacemaker, preexisting endocardial pacing leads, symptomatic bradycardia or second- or third-degree AV block, frequent or uncontrolled atrial tachyarrhythmia, or awaiting cardiac transplantation Interventions N=250 DDDR-70 pacing (dual-chamber rate-responsive pacing at 70/min) N=256 VVI-40 pacing (implantable cardioverter defibrillators programmed to ventricular backup pacing at 40/min) Primary outcome https://web.pathway.md/studies/recOFaaC3VUVBKuJt 1/2 6/28/23, 1:15 AM DAVID Pathway Survival free of death or hospitalization for new or worsened congestive heart failure at 1 year 83.9 % 83.9 73.3 62.9 % 42.0 % Significant increase 21.0 % NNT = 9 0.0 % DDDR-70 pacing VVI-40 pacing Significant increase in survival free of death or hospitalization for new or worsened congestive HF at 1 year (73.3% vs. 83.9%; RH 1.61, 95% CI 1.06 to 2.44) Secondary outcomes No significant difference in hospitalization for new or worsened congestive HF (22.6% vs. 13.3%; RH 1.54, 95% CI 0.97 to 2.46) No significant difference in death at 1 year (10.1% vs. 6.5%; RH 1.61, 95% CI 0.84 to 3.09) Safety outcomes No significant difference in severe adverse events within 30 days. Significant difference in early death (2.2% vs. 0.8%). Conclusion In patients with an indication for ICD, DDDR-70 pacing was inferior to VVI-40 pacing with respect to survival free of death or hospitalization for new or worsened congestive HF at 1 year. Reference Wilkoff BL, Cook JR, Epstein AE et al. Dual-chamber pacing or ventricular backup pacing in patients with an implantable defibrillator: the Dual Chamber and VVI Implantable Defibrillator (DAVID) Trial. JAMA. 2002 Dec 25;288(24):3115-23. Open reference URL https://web.pathway.md/studies/recOFaaC3VUVBKuJt 2/2