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Article: Atrial pacing for suppression of early reinitiation of atrial fibrillation after successful internal cardioversion

TitleAtrial pacing for suppression of early reinitiation of atrial fibrillation after successful internal cardioversion
Authors
Issue Date2000
PublisherOxford University Press. The Journal's web site is located at http://eurheartj.oxfordjournals.org/
Citation
European Heart Journal, 2000, v. 21 n. 14, p. 1167-1176 How to Cite?
AbstractAims. To evaluate the efficacy of atrial pacing in the suppression of early reinitiation of atrial fibrillation after successful internal cardioversion. Methods and Results. The efficacy of atrial pacing in suppressing early reinitiation of atrial fibrillation was studied in 12 of 45 (29%) patients with early reinitiation of atrial fibrillation after successful cardioversion. These patients were randomized to undergo either repeated defibrillation alone or repeated defibrillation followed by high right atrial pacing at 500 ms in a crossover fashion. In patients with persistent early reinitiation of atrial fibrillation despite atrial pacing at 500 ms and repeated defibrillation, atrial pacing at 300 ms was tested. Lastly, if early reinitiation of atrial fibrillation persisted, administration of intravenous sotalol (1.5 mg . kg-1) was tested. Atrial pacing at 500 ms after defibrillation prevented early reinitiation of atrial fibrillation in five of 12 (42%) patients, and was significantly more effective than repeated defibrillation (0/9 patients, 0%, P < 0.05). During atrial pacing at 500 ms, the density of atrial premature depolarizations (APDs) was significantly decreased (2.4 ± 2.4 APDs . min-1 vs 16.4 ± 9.8 APDs . min-1, P < 0.05) and the coupling interval of atrial premature depolarization was significantly increased (420 ± 32 ms vs 398 ± 19 ms, P < 0.05) as compared to no pacing. In the remaining seven (58%) patients, atrial pacing at 500 ms failed to prevent early reinitiation of atrial fibrillation, but significantly decreased the density of atrial premature depolarization (3.4 ± 2.4 APDs . min-1 vs 14.2 ± 4.8 APDs . min-1, P < 0.05) and delayed the onset of early reinitiation of atrial fibrillation (33 ± 17s vs 11 ± 11 s, P < 0.05). Atrial pacing at 300 ms decreased the coupling interval of atrial premature depolarization as compared to no pacing and during atrial pacing at 500 ms (P < 0.05), but without early reinitiation of atrial fibrillation suppression. Administration of intravenous sotalol was effective in preventing early reinitiation of atrial fibrillation in five of seven (71%) patients where pacing failed to suppress early reinitiation of atrial fibrillation. Conclusion. The results of this study suggest that atrial pacing can be useful when combined with transvenous defibrillation in patients with early reinitiation of atrial fibrillation. (C) 2000 The European Society of Cardiology.
Persistent Identifierhttp://hdl.handle.net/10722/162453
ISSN
2015 Impact Factor: 15.064
2015 SCImago Journal Rankings: 6.997
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorTse, HFen_US
dc.contributor.authorLau, CPen_US
dc.contributor.authorAyers, GMen_US
dc.date.accessioned2012-09-05T05:20:04Z-
dc.date.available2012-09-05T05:20:04Z-
dc.date.issued2000en_US
dc.identifier.citationEuropean Heart Journal, 2000, v. 21 n. 14, p. 1167-1176en_US
dc.identifier.issn0195-668Xen_US
dc.identifier.urihttp://hdl.handle.net/10722/162453-
dc.description.abstractAims. To evaluate the efficacy of atrial pacing in the suppression of early reinitiation of atrial fibrillation after successful internal cardioversion. Methods and Results. The efficacy of atrial pacing in suppressing early reinitiation of atrial fibrillation was studied in 12 of 45 (29%) patients with early reinitiation of atrial fibrillation after successful cardioversion. These patients were randomized to undergo either repeated defibrillation alone or repeated defibrillation followed by high right atrial pacing at 500 ms in a crossover fashion. In patients with persistent early reinitiation of atrial fibrillation despite atrial pacing at 500 ms and repeated defibrillation, atrial pacing at 300 ms was tested. Lastly, if early reinitiation of atrial fibrillation persisted, administration of intravenous sotalol (1.5 mg . kg-1) was tested. Atrial pacing at 500 ms after defibrillation prevented early reinitiation of atrial fibrillation in five of 12 (42%) patients, and was significantly more effective than repeated defibrillation (0/9 patients, 0%, P < 0.05). During atrial pacing at 500 ms, the density of atrial premature depolarizations (APDs) was significantly decreased (2.4 ± 2.4 APDs . min-1 vs 16.4 ± 9.8 APDs . min-1, P < 0.05) and the coupling interval of atrial premature depolarization was significantly increased (420 ± 32 ms vs 398 ± 19 ms, P < 0.05) as compared to no pacing. In the remaining seven (58%) patients, atrial pacing at 500 ms failed to prevent early reinitiation of atrial fibrillation, but significantly decreased the density of atrial premature depolarization (3.4 ± 2.4 APDs . min-1 vs 14.2 ± 4.8 APDs . min-1, P < 0.05) and delayed the onset of early reinitiation of atrial fibrillation (33 ± 17s vs 11 ± 11 s, P < 0.05). Atrial pacing at 300 ms decreased the coupling interval of atrial premature depolarization as compared to no pacing and during atrial pacing at 500 ms (P < 0.05), but without early reinitiation of atrial fibrillation suppression. Administration of intravenous sotalol was effective in preventing early reinitiation of atrial fibrillation in five of seven (71%) patients where pacing failed to suppress early reinitiation of atrial fibrillation. Conclusion. The results of this study suggest that atrial pacing can be useful when combined with transvenous defibrillation in patients with early reinitiation of atrial fibrillation. (C) 2000 The European Society of Cardiology.en_US
dc.languageengen_US
dc.publisherOxford University Press. The Journal's web site is located at http://eurheartj.oxfordjournals.org/en_US
dc.relation.ispartofEuropean Heart Journalen_US
dc.rightsEuropean Heart Journal. Copyright © Oxford University Press.-
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshAnti-Arrhythmia Agents - Administration & Dosageen_US
dc.subject.meshAtrial Fibrillation - Physiopathology - Therapyen_US
dc.subject.meshCardiac Pacing, Artificialen_US
dc.subject.meshElectric Countershock - Adverse Effectsen_US
dc.subject.meshElectrocardiography, Ambulatoryen_US
dc.subject.meshFemaleen_US
dc.subject.meshHeart Rateen_US
dc.subject.meshHumansen_US
dc.subject.meshInjections, Intravenousen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshProspective Studiesen_US
dc.subject.meshRecurrenceen_US
dc.subject.meshReproducibility Of Resultsen_US
dc.subject.meshSotalol - Administration & Dosageen_US
dc.titleAtrial pacing for suppression of early reinitiation of atrial fibrillation after successful internal cardioversionen_US
dc.typeArticleen_US
dc.identifier.emailTse, HF:hftse@hkucc.hku.hken_US
dc.identifier.authorityTse, HF=rp00428en_US
dc.description.naturelink_to_OA_fulltexten_US
dc.identifier.doi10.1053/euhj.1999.1991en_US
dc.identifier.pmid10924300-
dc.identifier.scopuseid_2-s2.0-0034662066en_US
dc.identifier.hkuros62109-
dc.identifier.hkuros100899-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0034662066&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume21en_US
dc.identifier.issue14en_US
dc.identifier.spage1167en_US
dc.identifier.epage1176en_US
dc.identifier.isiWOS:000088141500012-
dc.publisher.placeUnited Kingdomen_US
dc.identifier.scopusauthoridTse, HF=7006070805en_US
dc.identifier.scopusauthoridLau, CP=7401968501en_US
dc.identifier.scopusauthoridAyers, GM=7102015157en_US

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