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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Several studies have demonstrated the deleterious impact of conventional right ventricular apical pacing on cardiac performance&#44; particularly regarding the induction of ventricular dyssynchrony&#44; deterioration of left ventricular function and development of heart failure&#46; There is also a strong association with increased incidence of atrial fibrillation &#40;AF&#41; in patients requiring implantation of permanent pacemakers for sinus node disease &#40;SND&#41; or atrioventricular block &#40;AVB&#41;&#44; with or without prior paroxysmal AF&#46;<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">1&#8211;4</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The ideal pacing mode in patients with SND is still the subject of debate&#46; Despite previous studies showing that atrial-based pacing&#44; compared with ventricular pacing&#44; may reduce the occurrence of AF&#44; these patients may subsequently develop advanced AVB&#44; requiring ventricular pacing&#46; Also&#44; although atrial antitachycardia pacing &#40;ATP&#41; therapies have been associated with long-term reduction of the atrial tachyarrhythmias burden in patients with pacemakers&#44; the real clinical benefits of algorithms using ATP to prevent AF initiation are still under discussion&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">5</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The MINimizE Right Ventricular pacing to prevent Atrial fibrillation and heart failure &#40;MINERVA&#41; multicenter international randomized trial examined whether a combined pacing modality&#44; including atrial preventive pacing&#44; ATP and the managed ventricular pacing &#40;MVP&#41; algorithm&#44; designed to give priority to intrinsic ventricular activation and thereby minimize ventricular pacing&#44; reduced mortality&#44; morbidity&#44; or progression to permanent AF when compared with standard dual-chamber pacing&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">6</span></a> The main results showed that this combination of algorithms was associated with a statistically and clinically significant lower risk of a composite endpoint of death&#44; cardiovascular hospitalizations&#44; or progression to permanent AF at two-year follow-up&#44; compared with standard DDDR pacing in patients with bradycardia and paroxysmal or persistent atrial tachyarrhythmias&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Another study&#44; by Padeletti et al&#46;&#44; analyzed the MINERVA algorithm for the prevention of AF progression by randomly assigning patients to DDDR &#40;n&#61;385&#41;&#44; MVP &#40;n&#61;398&#41;&#44; or DDDR with ATP &#43; MVP &#40;n&#61;383&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">7</span></a> The best results were obtained using the combined algorithm of ATP &#43; MVP&#46; Permanent or persistent AF was significantly reduced in patients with high ATP efficacy &#40;hazard ratio &#91;HR&#93; 0&#46;32&#59; 95&#37; confidence interval &#91;CI&#93; 0&#46;13-0&#46;78&#59; p&#61;0&#46;012&#41; and in those with high atrial pacing &#40;HR 0&#46;98&#59; 95&#37; CI 0&#46;97-0&#46;99&#59; p&#61;0&#46;011&#41;&#59; conversely&#44; a higher risk of permanent or persistent AF was associated with higher ventricular pacing &#40;HR 1&#46;03&#59; 95&#37; CI 1&#46;02-1&#46;05&#59; p&#60;0&#46;001&#41;&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">In this issue of the <span class="elsevierStyleItalic">Journal</span>&#44; Sousa et al&#46; present the results of a complementary study in which they performed a healthcare cost analysis of enhanced pacing modalities in a Portuguese population&#44; based on the results of the MINERVA trial&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">8</span></a> Previously&#44; Boriani et al&#46; also performed a healthcare cost analysis focused on MINERVA&#44; with data from the USA&#44; Italy&#44; Spain and the UK&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">9</span></a> They demonstrated significant savings using this algorithm regarding utilization of AF-related health resources&#44; resulting in significant cost reductions in medical practice across these diverse healthcare systems&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The present study calculated the cost impact of the ATP&#43;MVP algorithm&#44; using the same methodology as in Boriani et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">9</span></a> with an analysis of the Portuguese tariffs for AF-related hospitalizations and for emergency department and unscheduled outpatient visits&#46; According to the authors&#44; the cost saving associated with the use of this combined algorithm could be 17<span class="elsevierStyleHsp" style=""></span>118 euros per 100 patients over a 10-year period &#40;the estimated lifetime of the device&#41;&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">These national tariffs&#44; based on data published by the Central Administration of the Portuguese National Health System &#40;ACSS&#41;&#44; do not consider specific costs for hospital admissions due to AF&#44; or for hospitalizations or outpatient or emergency care visits in patients with implantable pulse generators&#46;<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">10&#44;11</span></a> This may&#44; of course&#44; have led to underestimation of the associated healthcare costs in such a complex population&#46; Moreover&#44; there are no published data on the proportion of patients undergoing pacemaker implantation presenting with previous atrial tachyarrhythmias&#46; Portugal has one of the highest rates of pacemaker implantation in Europe &#40;1000 per million population&#41; &#40;Sanfins&#44; et al&#46; Registo Nacional de Pacing Card&#237;aco&#59; Associa&#231;&#227;o Portuguesa de Arritmologia&#44; Pacing e Eletrofisiologia&#59; Arritmias 2018 - oral communication&#41;&#46; Considering the growing prevalence of AF and the aging of the Portuguese population&#44; a reduction in AF-related health resource utilization could contribute to significant savings in the healthcare system&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Interestingly&#44; compared to the data from the USA&#44; the UK&#44; Italy&#44; and Spain used by Boriani et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">9</span></a> the average tariff&#47;costs per episode in Portugal were between 38&#37; and 72&#37; lower for hospital admissions&#44; and 22&#37; to 76&#37; lower for emergency department visits&#46; Costs associated with outpatient visits were higher than in Italy&#44; similar to those in Spain and lower than in the USA and the UK&#46; An update of the costs of healthcare utilization for specific clinical situations requiring hospitalizations and emergency care visits&#44; and costs of outpatient visits according to the type of cardiac electronic device implanted&#44; could potentially increase the cost savings calculated by Sousa et al&#46; In fact&#44; the MINERVA pacing algorithm was associated with reductions of 42&#37; and 68&#37; in the event rates for hospitalization and emergency department visits&#44; respectively&#44; which may also be associated with significant benefits regarding healthcare costs&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">7</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">Finally&#44; this analysis&#44; focusing on the cost savings obtained by using a combination of ATP &#43; MVP in patients with previous atrial arrhythmias undergoing dual-chamber pacemaker implantation due to SND&#44; did not take into consideration the pricing of the devices&#44; and it should therefore be borne in mind that the potential benefits assume that prices for these devices will remain similar&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0050" class="elsevierStylePara elsevierViewall">The author has no conflicts of interest to declare&#46;</p></span></span>"
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            0 => array:3 [
              "identificador" => "bib0060"
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The effects of right ventricular apical pacing on ventricular function and dyssynchrony implications for therapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "L&#46;F&#46; Tops"
                            1 => "M&#46;J&#46; Schalij"
                            2 => "J&#46;J&#46; Bax"
                          ]
                        ]
                      ]
                    ]
                  ]
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                    0 => array:2 [
                      "doi" => "10.1016/j.jacc.2009.06.006"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Coll Cardiol"
                        "fecha" => "2009"
                        "volumen" => "54"
                        "paginaInicial" => "764"
                        "paginaFinal" => "776"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19695453"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Influence of pacing modalities on the incidence of atrial fibrillation in patients without prior atrial fibrillation&#46; A prospective study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46;V&#46; Mattioli"
                            1 => "D&#46; Vivoli"
                            2 => "G&#46; Mattioli"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Heart J"
                        "fecha" => "1998"
                        "volumen" => "19"
                        "paginaInicial" => "282"
                        "paginaFinal" => "286"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9519322"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Adverse effect of ventricular pacing on heart failure and atrial fibrillation among patients with normal baseline QRS duration in a clinical trial of pacemaker therapy for sinus node dysfunction"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "MOde Selection Trial &#40;MOST&#41; Investigators"
                          "etal" => true
                          "autores" => array:3 [
                            0 => "M&#46; Sweeney"
                            1 => "A&#46; Hellkamp"
                            2 => "K&#46; Ellenbogen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/01.CIR.0000072769.17295.B1"
                      "Revista" => array:6 [
                        "tituloSerie" => "Circulation"
                        "fecha" => "2003"
                        "volumen" => "107"
                        "paginaInicial" => "2932"
                        "paginaFinal" => "3293"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12782566"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The relationship between right ventricular pacing and atrial fibrillation burden and disease progression in patients with paroxysmal atrial fibrillation&#58; the long-MinVPACE study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "R&#46; Veasey"
                            1 => "A&#46; Arya"
                            2 => "J&#46; Silberbauer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/europace/euq463"
                      "Revista" => array:6 [
                        "tituloSerie" => "Europace"
                        "fecha" => "2011"
                        "volumen" => "13"
                        "paginaInicial" => "815"
                        "paginaFinal" => "820"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21208945"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "High atrial antitachycardia pacing therapy efficacy is associated with a reduction in atrial tachyarrhythmia burden in a subset of patients with sinus node dysfunction and paroxysmal atrial fibrillation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "A&#46;M&#46; Gillis"
                            1 => "J&#46; Koehler"
                            2 => "M&#46; Morck"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.hrthm.2005.04.027"
                      "Revista" => array:6 [
                        "tituloSerie" => "Heart Rhythm"
                        "fecha" => "2005"
                        "volumen" => "2"
                        "paginaInicial" => "791"
                        "paginaFinal" => "796"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16051111"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0085"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Atrial antitachycardia pacing and managed ventricular pacing in bradycardia patients with paroxysmal or persistent atrial tachyarrhythmias&#58; the MINERVA randomized multicentre international trial"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "on behalf of the MINERVA Investigators"
                          "etal" => true
                          "autores" => array:3 [
                            0 => "G&#46; Boriani"
                            1 => "R&#46; Tukkie"
                            2 => "A&#46;S&#46; Manolis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/eurheartj/ehu165"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Heart J"
                        "fecha" => "2014"
                        "volumen" => "35"
                        "paginaInicial" => "2352"
                        "paginaFinal" => "2362"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24771721"
                            "web" => "Medline"
                          ]
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                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0090"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "New-generation atrial antitachycardia pacing &#40;Reactive ATP&#41; is associated with reduced risk of persistent or permanent atrial fibrillation in patients with bradycardia&#58; results from the MINERVA randomized multicenter international trial"
                      "autores" => array:1 [
                        0 => array:3 [
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                            1 => "H&#46; P&#252;rerfellner"
                            2 => "L&#46; Mont"
                          ]
                        ]
                      ]
                    ]
                  ]
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                ]
              ]
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Health care cost analysis of enhanced pacing modalities in bradycardia patients&#58; Portuguese case study on the results of the MINERVA trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "J&#46; de Sousa"
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                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.repc.2018.01.013"
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                        "paginaFinal" => "978"
                        "link" => array:1 [
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                            "web" => "Medline"
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                      ]
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                  ]
                ]
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            ]
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              "identificador" => "bib0100"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effects of enhanced pacing modalities on health care resource utilization and costs in bradycardia patients&#58; an analysis of the randomized MINERVA trial"
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                        0 => array:3 [
                          "colaboracion" => "on behalf of the MINERVA Investigators"
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                    ]
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.hrthm.2015.02.017"
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                        "tituloSerie" => "Heart Rhythm"
                        "fecha" => "2015"
                        "volumen" => "12"
                        "paginaInicial" => "1192"
                        "paginaFinal" => "1200"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25701774"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "referencia" => array:1 [
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                  "referenciaCompleta" => "Portaria no234&#47;2015 de 7 de Agosto&#46; Tabela Nacional dos Grupos de Diagn&#243;stico Homog&#233;neo&#59; 2015&#46;"
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              ]
            ]
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              "identificador" => "bib0110"
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                  "referenciaCompleta" => "ACSS &#40;Autoridade Central do Sistema de Sa&#250;de&#41;&#46; Base de dados dos elementos anal&#237;ticos&#59; 2009&#46;"
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              ]
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Editorial Comment
Enhanced pacing modalities in bradycardia patients: Can technology reduce costs?
Aperfeiçoamento das modalidades de pacing nos doentes com bradicardia: poderão as tecnologias reduzir os custos?
Mário Martins Oliveiraa,b,c
a Unidade de Arritmologia, Pacing e Eletrofisiologia (UNAPE), Centro Hospitalar Universitário Lisboa Central, Hospital de Santa Marta, Lisboa, Portugal
b Centro do Coração, Hospital CUF Infante Santo, Lisboa, Portugal
c Instituto de Fisiologia, Faculdade de Medicina de Lisboa, Lisboa, Portugal
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may reduce the occurrence of AF&#44; these patients may subsequently develop advanced AVB&#44; requiring ventricular pacing&#46; Also&#44; although atrial antitachycardia pacing &#40;ATP&#41; therapies have been associated with long-term reduction of the atrial tachyarrhythmias burden in patients with pacemakers&#44; the real clinical benefits of algorithms using ATP to prevent AF initiation are still under discussion&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">5</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The MINimizE Right Ventricular pacing to prevent Atrial fibrillation and heart failure &#40;MINERVA&#41; multicenter international randomized trial examined whether a combined pacing modality&#44; including atrial preventive pacing&#44; ATP and the managed ventricular pacing &#40;MVP&#41; algorithm&#44; designed to give priority to intrinsic ventricular activation and thereby minimize ventricular pacing&#44; reduced mortality&#44; morbidity&#44; or progression to permanent AF when compared with standard dual-chamber pacing&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">6</span></a> The main results showed that this combination of algorithms was associated with a statistically and clinically significant lower risk of a composite endpoint of death&#44; cardiovascular hospitalizations&#44; or progression to permanent AF at two-year follow-up&#44; compared with standard DDDR pacing in patients with bradycardia and paroxysmal or persistent atrial tachyarrhythmias&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Another study&#44; by Padeletti et al&#46;&#44; analyzed the MINERVA algorithm for the prevention of AF progression by randomly assigning patients to DDDR &#40;n&#61;385&#41;&#44; MVP &#40;n&#61;398&#41;&#44; or DDDR with ATP &#43; MVP &#40;n&#61;383&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">7</span></a> The best results were obtained using the combined algorithm of ATP &#43; MVP&#46; Permanent or persistent AF was significantly reduced in patients with high ATP efficacy &#40;hazard ratio &#91;HR&#93; 0&#46;32&#59; 95&#37; confidence interval &#91;CI&#93; 0&#46;13-0&#46;78&#59; p&#61;0&#46;012&#41; and in those with high atrial pacing &#40;HR 0&#46;98&#59; 95&#37; CI 0&#46;97-0&#46;99&#59; p&#61;0&#46;011&#41;&#59; conversely&#44; a higher risk of permanent or persistent AF was associated with higher ventricular pacing &#40;HR 1&#46;03&#59; 95&#37; CI 1&#46;02-1&#46;05&#59; p&#60;0&#46;001&#41;&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">In this issue of the <span class="elsevierStyleItalic">Journal</span>&#44; Sousa et al&#46; present the results of a complementary study in which they performed a healthcare cost analysis of enhanced pacing modalities in a Portuguese population&#44; based on the results of the MINERVA trial&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">8</span></a> Previously&#44; Boriani et al&#46; also performed a healthcare cost analysis focused on MINERVA&#44; with data from the USA&#44; Italy&#44; Spain and the UK&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">9</span></a> They demonstrated significant savings using this algorithm regarding utilization of AF-related health resources&#44; resulting in significant cost reductions in medical practice across these diverse healthcare systems&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The present study calculated the cost impact of the ATP&#43;MVP algorithm&#44; using the same methodology as in Boriani et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">9</span></a> with an analysis of the Portuguese tariffs for AF-related hospitalizations and for emergency department and unscheduled outpatient visits&#46; According to the authors&#44; the cost saving associated with the use of this combined algorithm could be 17<span class="elsevierStyleHsp" style=""></span>118 euros per 100 patients over a 10-year period &#40;the estimated lifetime of the device&#41;&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">These national tariffs&#44; based on data published by the Central Administration of the Portuguese National Health System &#40;ACSS&#41;&#44; do not consider specific costs for hospital admissions due to AF&#44; or for hospitalizations or outpatient or emergency care visits in patients with implantable pulse generators&#46;<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">10&#44;11</span></a> This may&#44; of course&#44; have led to underestimation of the associated healthcare costs in such a complex population&#46; Moreover&#44; there are no published data on the proportion of patients undergoing pacemaker implantation presenting with previous atrial tachyarrhythmias&#46; Portugal has one of the highest rates of pacemaker implantation in Europe &#40;1000 per million population&#41; &#40;Sanfins&#44; et al&#46; Registo Nacional de Pacing Card&#237;aco&#59; Associa&#231;&#227;o Portuguesa de Arritmologia&#44; Pacing e Eletrofisiologia&#59; Arritmias 2018 - oral communication&#41;&#46; Considering the growing prevalence of AF and the aging of the Portuguese population&#44; a reduction in AF-related health resource utilization could contribute to significant savings in the healthcare system&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Interestingly&#44; compared to the data from the USA&#44; the UK&#44; Italy&#44; and Spain used by Boriani et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">9</span></a> the average tariff&#47;costs per episode in Portugal were between 38&#37; and 72&#37; lower for hospital admissions&#44; and 22&#37; to 76&#37; lower for emergency department visits&#46; Costs associated with outpatient visits were higher than in Italy&#44; similar to those in Spain and lower than in the USA and the UK&#46; An update of the costs of healthcare utilization for specific clinical situations requiring hospitalizations and emergency care visits&#44; and costs of outpatient visits according to the type of cardiac electronic device implanted&#44; could potentially increase the cost savings calculated by Sousa et al&#46; In fact&#44; the MINERVA pacing algorithm was associated with reductions of 42&#37; and 68&#37; in the event rates for hospitalization and emergency department visits&#44; respectively&#44; which may also be associated with significant benefits regarding healthcare costs&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">7</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">Finally&#44; this analysis&#44; focusing on the cost savings obtained by using a combination of ATP &#43; MVP in patients with previous atrial arrhythmias undergoing dual-chamber pacemaker implantation due to SND&#44; did not take into consideration the pricing of the devices&#44; and it should therefore be borne in mind that the potential benefits assume that prices for these devices will remain similar&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0050" class="elsevierStylePara elsevierViewall">The author has no conflicts of interest to declare&#46;</p></span></span>"
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            0 => array:3 [
              "identificador" => "bib0060"
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The effects of right ventricular apical pacing on ventricular function and dyssynchrony implications for therapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "L&#46;F&#46; Tops"
                            1 => "M&#46;J&#46; Schalij"
                            2 => "J&#46;J&#46; Bax"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jacc.2009.06.006"
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                        "tituloSerie" => "J Am Coll Cardiol"
                        "fecha" => "2009"
                        "volumen" => "54"
                        "paginaInicial" => "764"
                        "paginaFinal" => "776"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19695453"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
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            1 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Influence of pacing modalities on the incidence of atrial fibrillation in patients without prior atrial fibrillation&#46; A prospective study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46;V&#46; Mattioli"
                            1 => "D&#46; Vivoli"
                            2 => "G&#46; Mattioli"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Heart J"
                        "fecha" => "1998"
                        "volumen" => "19"
                        "paginaInicial" => "282"
                        "paginaFinal" => "286"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9519322"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Adverse effect of ventricular pacing on heart failure and atrial fibrillation among patients with normal baseline QRS duration in a clinical trial of pacemaker therapy for sinus node dysfunction"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "MOde Selection Trial &#40;MOST&#41; Investigators"
                          "etal" => true
                          "autores" => array:3 [
                            0 => "M&#46; Sweeney"
                            1 => "A&#46; Hellkamp"
                            2 => "K&#46; Ellenbogen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/01.CIR.0000072769.17295.B1"
                      "Revista" => array:6 [
                        "tituloSerie" => "Circulation"
                        "fecha" => "2003"
                        "volumen" => "107"
                        "paginaInicial" => "2932"
                        "paginaFinal" => "3293"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12782566"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0075"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The relationship between right ventricular pacing and atrial fibrillation burden and disease progression in patients with paroxysmal atrial fibrillation&#58; the long-MinVPACE study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "R&#46; Veasey"
                            1 => "A&#46; Arya"
                            2 => "J&#46; Silberbauer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/europace/euq463"
                      "Revista" => array:6 [
                        "tituloSerie" => "Europace"
                        "fecha" => "2011"
                        "volumen" => "13"
                        "paginaInicial" => "815"
                        "paginaFinal" => "820"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21208945"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "High atrial antitachycardia pacing therapy efficacy is associated with a reduction in atrial tachyarrhythmia burden in a subset of patients with sinus node dysfunction and paroxysmal atrial fibrillation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "A&#46;M&#46; Gillis"
                            1 => "J&#46; Koehler"
                            2 => "M&#46; Morck"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.hrthm.2005.04.027"
                      "Revista" => array:6 [
                        "tituloSerie" => "Heart Rhythm"
                        "fecha" => "2005"
                        "volumen" => "2"
                        "paginaInicial" => "791"
                        "paginaFinal" => "796"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16051111"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Atrial antitachycardia pacing and managed ventricular pacing in bradycardia patients with paroxysmal or persistent atrial tachyarrhythmias&#58; the MINERVA randomized multicentre international trial"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "on behalf of the MINERVA Investigators"
                          "etal" => true
                          "autores" => array:3 [
                            0 => "G&#46; Boriani"
                            1 => "R&#46; Tukkie"
                            2 => "A&#46;S&#46; Manolis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/eurheartj/ehu165"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Heart J"
                        "fecha" => "2014"
                        "volumen" => "35"
                        "paginaInicial" => "2352"
                        "paginaFinal" => "2362"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24771721"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0090"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "New-generation atrial antitachycardia pacing &#40;Reactive ATP&#41; is associated with reduced risk of persistent or permanent atrial fibrillation in patients with bradycardia&#58; results from the MINERVA randomized multicenter international trial"
                      "autores" => array:1 [
                        0 => array:3 [
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                          "autores" => array:3 [
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                            1 => "H&#46; P&#252;rerfellner"
                            2 => "L&#46; Mont"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
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                        "tituloSerie" => "Heart Rhythm"
                        "fecha" => "2015"
                        "volumen" => "12"
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                    ]
                  ]
                ]
              ]
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Health care cost analysis of enhanced pacing modalities in bradycardia patients&#58; Portuguese case study on the results of the MINERVA trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "J&#46; de Sousa"
                            1 => "P&#46; Marques"
                            2 => "V&#46; Martins"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.repc.2018.01.013"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Port Cardiol"
                        "fecha" => "2018"
                        "volumen" => "37"
                        "paginaInicial" => "973"
                        "paginaFinal" => "978"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30528686"
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                ]
              ]
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              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Effects of enhanced pacing modalities on health care resource utilization and costs in bradycardia patients&#58; an analysis of the randomized MINERVA trial"
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                        0 => array:3 [
                          "colaboracion" => "on behalf of the MINERVA Investigators"
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                            2 => "R&#46; Tukkie"
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                        "fecha" => "2015"
                        "volumen" => "12"
                        "paginaInicial" => "1192"
                        "paginaFinal" => "1200"
                        "link" => array:1 [
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                    ]
                  ]
                ]
              ]
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                  "referenciaCompleta" => "Portaria no234&#47;2015 de 7 de Agosto&#46; Tabela Nacional dos Grupos de Diagn&#243;stico Homog&#233;neo&#59; 2015&#46;"
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              ]
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                  "referenciaCompleta" => "ACSS &#40;Autoridade Central do Sistema de Sa&#250;de&#41;&#46; Base de dados dos elementos anal&#237;ticos&#59; 2009&#46;"
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              ]
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