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Article: Dual-site atrial pacing for atrial fibrillation in patients without bradycardia

TitleDual-site atrial pacing for atrial fibrillation in patients without bradycardia
Authors
Issue Date2001
PublisherExcerpta Medica, Inc.. The Journal's web site is located at http://www.ajconline.org/
Citation
American Journal Of Cardiology, 2001, v. 88 n. 4, p. 371-375 How to Cite?
AbstractAtrial pacing has been shown to delay the onset of atrial fibrillation (AF) when compared with ventricular pacing in patients with sick sinus syndrome. The role for pacing in the control of AF in patients without bradycardia is uncertain. We performed a randomized, crossover, single-blinded study in 22 patients (14 women, aged 63 ± 10 years) with paroxysmal AF refractory to treatment with oral sotalol (202 ± 68 mg/day) and no bradycardic indication for pacing. All patients received a dual-chamber pacemaker with 2 atrial pacing leads positioned at the high right atrium and coronary sinus ostium, respectively. Patients were randomized in a crossover fashion to be paced for 12 weeks, either with high right atrial (RA) pacing at 30 beats/min ("Off") or dual-site RA pacing with an overdrive algorithm that maintained atrial pacing at a rate slightly above the sinus rate ("On"). Treatment on resulted in a significantly higher percentage of atrial pacing and a reduction in atrial ectopic frequency than the treatment off period. The time to the first clinical AF recurrence was prolonged (15 ± 17 to 50 ± 35 days, p = 0.006), and total AF burden was reduced (45 ± 34% vs 22 ± 29%, p = 0.04) in the on-treatment phase. However, there was no difference in AF checklist symptom scores or overall quality-of-life measures. Dual-site RA pacing with continued sinus overdrive prolonged the time to AF recurrence and decreased AF burden in patients with paroxysmal AF. The absence of a major impact on symptom control suggests that pacing should be used as an adjunctive therapy with other treatment modalities for AF. © 2001 by Excerpta Medica, Inc.
Persistent Identifierhttp://hdl.handle.net/10722/78484
ISSN
2015 Impact Factor: 3.154
2015 SCImago Journal Rankings: 2.063
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLau, CPen_HK
dc.contributor.authorTse, HFen_HK
dc.contributor.authorYu, CMen_HK
dc.contributor.authorTeo, WSen_HK
dc.contributor.authorKam, Ren_HK
dc.contributor.authorNg, KSen_HK
dc.contributor.authorHuang, SSKen_HK
dc.contributor.authorLin, JLen_HK
dc.contributor.authorFitts, SMen_HK
dc.contributor.authorHettrick, DAen_HK
dc.contributor.authorHill, MRSen_HK
dc.date.accessioned2010-09-06T07:43:24Z-
dc.date.available2010-09-06T07:43:24Z-
dc.date.issued2001en_HK
dc.identifier.citationAmerican Journal Of Cardiology, 2001, v. 88 n. 4, p. 371-375en_HK
dc.identifier.issn0002-9149en_HK
dc.identifier.urihttp://hdl.handle.net/10722/78484-
dc.description.abstractAtrial pacing has been shown to delay the onset of atrial fibrillation (AF) when compared with ventricular pacing in patients with sick sinus syndrome. The role for pacing in the control of AF in patients without bradycardia is uncertain. We performed a randomized, crossover, single-blinded study in 22 patients (14 women, aged 63 ± 10 years) with paroxysmal AF refractory to treatment with oral sotalol (202 ± 68 mg/day) and no bradycardic indication for pacing. All patients received a dual-chamber pacemaker with 2 atrial pacing leads positioned at the high right atrium and coronary sinus ostium, respectively. Patients were randomized in a crossover fashion to be paced for 12 weeks, either with high right atrial (RA) pacing at 30 beats/min ("Off") or dual-site RA pacing with an overdrive algorithm that maintained atrial pacing at a rate slightly above the sinus rate ("On"). Treatment on resulted in a significantly higher percentage of atrial pacing and a reduction in atrial ectopic frequency than the treatment off period. The time to the first clinical AF recurrence was prolonged (15 ± 17 to 50 ± 35 days, p = 0.006), and total AF burden was reduced (45 ± 34% vs 22 ± 29%, p = 0.04) in the on-treatment phase. However, there was no difference in AF checklist symptom scores or overall quality-of-life measures. Dual-site RA pacing with continued sinus overdrive prolonged the time to AF recurrence and decreased AF burden in patients with paroxysmal AF. The absence of a major impact on symptom control suggests that pacing should be used as an adjunctive therapy with other treatment modalities for AF. © 2001 by Excerpta Medica, Inc.en_HK
dc.languageengen_HK
dc.publisherExcerpta Medica, Inc.. The Journal's web site is located at http://www.ajconline.org/en_HK
dc.relation.ispartofAmerican Journal of Cardiologyen_HK
dc.subject.meshAdolescenten_HK
dc.subject.meshAdulten_HK
dc.subject.meshAgeden_HK
dc.subject.meshAged, 80 and overen_HK
dc.subject.meshAlgorithmsen_HK
dc.subject.meshAtrial Fibrillation - therapyen_HK
dc.subject.meshCardiac Pacing, Artificial - methodsen_HK
dc.subject.meshCross-Over Studiesen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshHumansen_HK
dc.subject.meshLife Tablesen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshProspective Studiesen_HK
dc.subject.meshSingle-Blind Methoden_HK
dc.titleDual-site atrial pacing for atrial fibrillation in patients without bradycardiaen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0002-9149&volume=88&spage=371&epage=5&date=2001&atitle=Dual-site+atrial+pacing+for+atrial+fibrillation+in+patients+without+bradycardia.en_HK
dc.identifier.emailTse, HF:hftse@hkucc.hku.hken_HK
dc.identifier.authorityTse, HF=rp00428en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/S0002-9149(01)01681-2en_HK
dc.identifier.pmid11545756-
dc.identifier.scopuseid_2-s2.0-0035880614en_HK
dc.identifier.hkuros74774en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0035880614&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume88en_HK
dc.identifier.issue4en_HK
dc.identifier.spage371en_HK
dc.identifier.epage375en_HK
dc.identifier.isiWOS:000170344300007-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridLau, CP=7401968501en_HK
dc.identifier.scopusauthoridTse, HF=7006070805en_HK
dc.identifier.scopusauthoridYu, CM=7404976646en_HK
dc.identifier.scopusauthoridTeo, WS=35847188300en_HK
dc.identifier.scopusauthoridKam, R=7003969283en_HK
dc.identifier.scopusauthoridNg, KS=36898897500en_HK
dc.identifier.scopusauthoridHuang, SSK=27168507700en_HK
dc.identifier.scopusauthoridLin, JL=26326664300en_HK
dc.identifier.scopusauthoridFitts, SM=6701730254en_HK
dc.identifier.scopusauthoridHettrick, DA=7007092525en_HK
dc.identifier.scopusauthoridHill, MRS=7404447705en_HK

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