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Article: Effects of right low atrial septal vs. right atrial appendage pacing on atrial mechanical function and dyssynchrony in patients with sinus node dysfunction and paroxysmal atrial fibrillation
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TitleEffects of right low atrial septal vs. right atrial appendage pacing on atrial mechanical function and dyssynchrony in patients with sinus node dysfunction and paroxysmal atrial fibrillation
 
AuthorsWang, M2 1
Siu, CW2 1
Lee, KLF
Yue, WS2
Yan, GH2
Lee, S2
Lau, CP2
Tse, HF2 1
 
Issue Date2011
 
PublisherOxford University Press. The Journal's web site is located at http://europace.oxfordjournals.org/
 
CitationEuropace, 2011, v. 13 n. 9, p. 1268-1274 [How to Cite?]
DOI: http://dx.doi.org/10.1093/europace/eur110
 
AbstractAIMS: To study the effects of right low atrial septum (AS) and right atrial appendage (RAA) pacing on atrial mechanical function and dyssynchrony in patients with sinus node disease (SND) and paroxysmal atrial fibrillation (AF). METHODS AND RESULTS: Detailed echocardiographic examination was performed on 30 patients with SND and paroxysmal AF and a dual-chamber, dual sensing, dual response pacemaker with atrial lead implantation at AS(n= 15) or RAA(n= 15). Peak atrial velocities were recorded by pulsed tissue Doppler spectrum. The timing of atrial contractions (Ta) was measured at the middle of the left atrial (LA) and right atrial (RA) free wall. Intra-[standard deviation (SD) of time of Ta (Ta-SD)] and inter-atrial delay(Ta-RL) was measured as the SD of time interval among LA six segments and time difference between the LA and RA wall, respectively. The baseline clinical statuses were similar between groups. Indexes of LA function, and intra- or inter-atrial dyssynchrony were also similar during intrinsic sinus rhythm in both groups (all P> 0.05). During atrial pacing, LA ejection fraction (52 +/- 16 vs. 39 +/- 14%, P= 0.029) and LA active emptying fraction (34 +/- 7 vs. 23 +/- 15%, P= 0.012) were higher in patients with AS than RAA pacing. Atrial velocity was also higher at the RA free wall (14.3 +/- 3.1 vs. 10.3 +/- 4.4 cm/s, P= 0.009), LA septal (7.5 +/- 2.1 vs. 5.2 +/- 1.7 cm/s, P= 0.004) and lateral wall (8.6 +/- 2.4 vs. 6.3 +/- 3.0 cm/s, P= 0.024) during AS compared with RAA pacing. There was no difference in Ts-SD during atrial pacing, nevertheless Ta-RL was significantly prolonged in patients with RAA compared with those with AS pacing (42 +/- 36 vs. 27 +/- 25 ms, P= 0.011). CONCLUSION: In patients with SND and paroxysmal AF, right low AS pacing significantly improved global and regional atrial mechanical function and synchronized inter-atrial electromechanical contraction compared with RAA pacing.
 
ISSN1099-5129
2012 Impact Factor: 2.765
2012 SCImago Journal Rankings: 1.264
 
DOIhttp://dx.doi.org/10.1093/europace/eur110
 
ISI Accession Number IDWOS:000294440000012
Funding AgencyGrant Number
Research Grant Council of Hong KongHKU 7777/07M
HKU 7775/08M
Funding Information:

This study was supported by General Research Fund of Research Grant Council of Hong Kong (HKU 7777/07M and HKU 7775/08M).

 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorWang, M
 
dc.contributor.authorSiu, CW
 
dc.contributor.authorLee, KLF
 
dc.contributor.authorYue, WS
 
dc.contributor.authorYan, GH
 
dc.contributor.authorLee, S
 
dc.contributor.authorLau, CP
 
dc.contributor.authorTse, HF
 
dc.date.accessioned2010-09-06T07:25:59Z
 
dc.date.available2010-09-06T07:25:59Z
 
dc.date.issued2011
 
dc.description.abstractAIMS: To study the effects of right low atrial septum (AS) and right atrial appendage (RAA) pacing on atrial mechanical function and dyssynchrony in patients with sinus node disease (SND) and paroxysmal atrial fibrillation (AF). METHODS AND RESULTS: Detailed echocardiographic examination was performed on 30 patients with SND and paroxysmal AF and a dual-chamber, dual sensing, dual response pacemaker with atrial lead implantation at AS(n= 15) or RAA(n= 15). Peak atrial velocities were recorded by pulsed tissue Doppler spectrum. The timing of atrial contractions (Ta) was measured at the middle of the left atrial (LA) and right atrial (RA) free wall. Intra-[standard deviation (SD) of time of Ta (Ta-SD)] and inter-atrial delay(Ta-RL) was measured as the SD of time interval among LA six segments and time difference between the LA and RA wall, respectively. The baseline clinical statuses were similar between groups. Indexes of LA function, and intra- or inter-atrial dyssynchrony were also similar during intrinsic sinus rhythm in both groups (all P> 0.05). During atrial pacing, LA ejection fraction (52 +/- 16 vs. 39 +/- 14%, P= 0.029) and LA active emptying fraction (34 +/- 7 vs. 23 +/- 15%, P= 0.012) were higher in patients with AS than RAA pacing. Atrial velocity was also higher at the RA free wall (14.3 +/- 3.1 vs. 10.3 +/- 4.4 cm/s, P= 0.009), LA septal (7.5 +/- 2.1 vs. 5.2 +/- 1.7 cm/s, P= 0.004) and lateral wall (8.6 +/- 2.4 vs. 6.3 +/- 3.0 cm/s, P= 0.024) during AS compared with RAA pacing. There was no difference in Ts-SD during atrial pacing, nevertheless Ta-RL was significantly prolonged in patients with RAA compared with those with AS pacing (42 +/- 36 vs. 27 +/- 25 ms, P= 0.011). CONCLUSION: In patients with SND and paroxysmal AF, right low AS pacing significantly improved global and regional atrial mechanical function and synchronized inter-atrial electromechanical contraction compared with RAA pacing.
 
dc.description.naturelink_to_OA_fulltext
 
dc.identifier.citationEuropace, 2011, v. 13 n. 9, p. 1268-1274 [How to Cite?]
DOI: http://dx.doi.org/10.1093/europace/eur110
 
dc.identifier.citeulike9312469
 
dc.identifier.doihttp://dx.doi.org/10.1093/europace/eur110
 
dc.identifier.epage1274
 
dc.identifier.hkuros208717
 
dc.identifier.isiWOS:000294440000012
Funding AgencyGrant Number
Research Grant Council of Hong KongHKU 7777/07M
HKU 7775/08M
Funding Information:

This study was supported by General Research Fund of Research Grant Council of Hong Kong (HKU 7777/07M and HKU 7775/08M).

 
dc.identifier.issn1099-5129
2012 Impact Factor: 2.765
2012 SCImago Journal Rankings: 1.264
 
dc.identifier.issue9
 
dc.identifier.pmid21515592
 
dc.identifier.scopuseid_2-s2.0-80052203448
 
dc.identifier.spage1268
 
dc.identifier.urihttp://hdl.handle.net/10722/76887
 
dc.identifier.volume13
 
dc.languageeng
 
dc.publisherOxford University Press. The Journal's web site is located at http://europace.oxfordjournals.org/
 
dc.publisher.placeUnited Kingdom
 
dc.relation.ispartofEuropace
 
dc.relation.referencesReferences in Scopus
 
dc.subject.meshAtrial Appendage - physiopathology - ultrasonography
 
dc.subject.meshAtrial Fibrillation - physiopathology - therapy - ultrasonography
 
dc.subject.meshAtrial Septum - physiopathology - ultrasonography
 
dc.subject.meshCardiac Pacing, Artificial
 
dc.subject.meshSick Sinus Syndrome - physiopathology - ultrasonography
 
dc.titleEffects of right low atrial septal vs. right atrial appendage pacing on atrial mechanical function and dyssynchrony in patients with sinus node dysfunction and paroxysmal atrial fibrillation
 
dc.typeArticle
 
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<contributor.author>Yan, GH</contributor.author>
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<contributor.author>Tse, HF</contributor.author>
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Author Affiliations
  1. The University of Hong Kong Li Ka Shing Faculty of Medicine
  2. The University of Hong Kong