{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T17:50:15Z","timestamp":1788285015127,"version":"build-2803163510"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2023,3,28]],"date-time":"2023-03-28T00:00:00Z","timestamp":1679961600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"QUOVADIS"},{"name":"Boston Scientific International SA"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,5,19]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>In patients with prolonged atrioventricular (AV) conduction and pacemaker (PM) indication due to sinus node disease (SND) or intermittent AV-block who do not need continuous ventricular pacing (VP), it may be difficult to determine which strategy to adopt. Currently, the standard of care is to minimize unnecessary VP by specific VP avoidance (VPA) algorithms. The superiority of this strategy over standard DDD or DDD rate-responsive (DDD\/DDDR) in improving clinical outcomes is controversial, probably owing to the prolongation of the atrialventricular conduction (PR interval) caused by the algorithms. Conduction system pacing (CSP) may offer the most physiological-VP approach, providing appropriate AV conduction and preventing pacing-induced dyssynchrony.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>PhysioVP-AF is a prospective, controlled, randomized, single-blind trial designed to determine whether atrial-synchronized conduction system pacing (DDD-CSP) is superior to standard DDD-VPA pacing in terms of 3-year reduction of persistent-AF occurrence. Cardiovascular hospitalization, quality-of-life, and safety will be evaluated. Patients with indication for permanent DDD pacing for SND or intermittent AV-block and prolonged AV conduction (PR interval &amp;gt; 180\u2005ms) will be randomized (1:1 ratio) to DDD-VPA (VPA-algorithms ON, septal\/apex position) or to DDD-CSP (His bundle or left bundle branch area pacing, AV-delay setting to control PR interval, VPA-algorithms OFF). Approximately 400 patients will be randomized in 24 months in 13 Italian centres.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The PhysioVP-AF study will provide an essential contribution to patient management with prolonged AV conduction and PM indication for sinus nodal disease or paroxysmal 2nd-degree AV-block by determining whether CSP combined with a controlled PR interval is superior to standard management that minimizes unnecessary VP in terms of reducing clinical outcomes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/europace\/euad082","type":"journal-article","created":{"date-parts":[[2023,3,28]],"date-time":"2023-03-28T16:35:43Z","timestamp":1680021343000},"source":"Crossref","is-referenced-by-count":9,"title":["The PhysioVP-AF study, a randomized controlled trial to assess the clinical benefit of physiological ventricular pacing vs. managed ventricular pacing for persistent atrial fibrillation prevention in patients with prolonged atrioventricular conduction: design and rationale"],"prefix":"10.1093","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4040-3838","authenticated-orcid":false,"given":"Gianni","family":"Pastore","sequence":"first","affiliation":[{"name":"Department of Cardiology, Santa Maria della Misericordia Hospital , Via Tre Martiri 140, 45100 Rovigo , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5285-7140","authenticated-orcid":false,"given":"Matteo","family":"Bertini","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital , via Aldo Moro, n 8, 44124 Ferrara , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Bonanno","sequence":"additional","affiliation":[{"name":"Department of Cardiology, San Bortolo Hospital , Viale Rodolfi 37, 36100 Vicenza , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0292-5202","authenticated-orcid":false,"given":"Giovanni","family":"Coluccia","sequence":"additional","affiliation":[{"name":"Department of Cardiology, C. 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Panico Hospital , via San Pio X 4, 73039 Lecce Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7517-0771","authenticated-orcid":false,"given":"Gabriele","family":"Dell'Era","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maggiore della Carit\u00e0 Hospital , corso Mazzini 18, 28100 Novara , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4979-7300","authenticated-orcid":false,"given":"Luca","family":"De Mattia","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Ca\u2019 Foncello Hospital , Piazzale Ospedale 1, 31100 Treviso , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3899-3023","authenticated-orcid":false,"given":"Domenico","family":"Grieco","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Policlinico Casilino , via Casilina n.1049, 00169 Roma , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0324-5623","authenticated-orcid":false,"given":"Grigorius","family":"Katsouras","sequence":"additional","affiliation":[{"name":"Department of Cardiology, F. Miulli Hospital , Strada Provinciale 127, 70021 Acquaviva delle Fonti, BA , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimiliano","family":"Maines","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Santa Maria del Carmine Hospital , corso Verona 4, 38068 Rovereto, TN , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5854-9782","authenticated-orcid":false,"given":"Lina","family":"Marcantoni","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Santa Maria della Misericordia Hospital , Via Tre Martiri 140, 45100 Rovigo , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7480-2861","authenticated-orcid":false,"given":"Leonardo","family":"Marinaccio","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Immacolata Concezione Hospital , via San Rocco 8, 35028 Piove di Sacco, PD , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Paglino","sequence":"additional","affiliation":[{"name":"Department of Cardiology, IRCCS San Raffaele Hospital , via Olgettina 60, 20132 Milano , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6705-6218","authenticated-orcid":false,"given":"Pietro","family":"Palmisano","sequence":"additional","affiliation":[{"name":"Department of Cardiology, C. 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