Therapy

Use atrial pacing ^a

Why?

• It reduces death, stroke and arterial embolism ^a when compared with ventricular pacing

Sick sinus syndrome: atrial pacing reduces death and thromboembolism compared with ventricular pacing

Patient	Treatment	Comparison	Outcome	CER	RRR (95% CI)	NNH (95% CI)
sick sinus syndrome requiring a first pacemaker a	atrial pacing	ventricular pacing	death at 5.5 years	50%	28% (2% to 48%)	7 (4 to 75)
			thromboembolic event at 5.5 years	23%	48% (4% to 72%)	9 (5 to 95)

• Dual chamber pacing is not clearly better than ventricular pacing ^d