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Article: Efficacy and tolerability of continuous overdrive atrial pacing in atrial fibrillation

TitleEfficacy and tolerability of continuous overdrive atrial pacing in atrial fibrillation
Authors
Issue Date2000
PublisherOxford University Press. The Journal's web site is located at http://europace.oxfordjournals.org/
Citation
Europace, 2000, v. 2 n. 4, p. 286-291 How to Cite?
AbstractOverdrive right atrial pacing has been used to prevent atrial fibrillation, but its efficacy in atrial fibrillation prevention and the patient tolerability and quality of life during high rate pacing remain uncertain. The objective of this study was to test the effects of a consistent atrial pacing algorithm that automatically paced the atrium at 30ms shorter than the sinus P-P interval for atrial fibrillation prevention. Fifteen patients with sick sinus syndrome implanted with a Thera DR (model 7940 or 7960, Medtronic Inc.) were randomly programmed to rate adaptive dual chamber pacing (DDDR) or DDDR+consistent atrial pacing mode, each for an 8-week study period. The efficacy of consistent atrial pacing was assessed by the number of automatic mode switching and the number of premature atrial complexes. Symptoms and quality of life were assessed by the SF-36 quality of life questionnaire and an atrial fibrillation symptom checklist. The percentage of atrial pacing increased from 57±32% to 86±28%. Overall, there was no significant difference in the number of automatic mode switching episodes between DDDR and DDDR+ consistent atrial pacing (47±90 vs 42±87, P> 0·05), but a significant reduction in premature atrial complexes by 74·7% (P< 0·001). There was no undue increase in atrial rate by the DDDR+consistent atrial pacing mode versus DDDR (63±13 vs 70±7bpm). There was no significant difference in quality of life scores and symptom severity on frequency between the two modes of pacing, but a trend towards a lower frequency of symptoms in the DDDR+consistent atrial pacing mode compared with baseline (29·5±10·2 vs 25·1±9·7, P=0·07). An algorithm that provides consistent atrial overdrive pacing can suppress atrial fibrillation triggering premature atrial complexes without the need to increase the overall atrial rate compared with conventional pacing. The algorithm appears to be well-tolerated, but further studies are needed to address the clinical impact of this atrial fibrillation prevention algorithm. © 2000 The European Society of Cardiology.
Persistent Identifierhttp://hdl.handle.net/10722/78709
ISSN
2015 Impact Factor: 4.021
2015 SCImago Journal Rankings: 2.201
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLam, CTFen_HK
dc.contributor.authorLau, CPen_HK
dc.contributor.authorLeung, SKen_HK
dc.contributor.authorTse, HFen_HK
dc.contributor.authorLee, KLFen_HK
dc.contributor.authorTang, MOen_HK
dc.contributor.authorTsang, Ven_HK
dc.date.accessioned2010-09-06T07:45:52Z-
dc.date.available2010-09-06T07:45:52Z-
dc.date.issued2000en_HK
dc.identifier.citationEuropace, 2000, v. 2 n. 4, p. 286-291en_HK
dc.identifier.issn1099-5129en_HK
dc.identifier.urihttp://hdl.handle.net/10722/78709-
dc.description.abstractOverdrive right atrial pacing has been used to prevent atrial fibrillation, but its efficacy in atrial fibrillation prevention and the patient tolerability and quality of life during high rate pacing remain uncertain. The objective of this study was to test the effects of a consistent atrial pacing algorithm that automatically paced the atrium at 30ms shorter than the sinus P-P interval for atrial fibrillation prevention. Fifteen patients with sick sinus syndrome implanted with a Thera DR (model 7940 or 7960, Medtronic Inc.) were randomly programmed to rate adaptive dual chamber pacing (DDDR) or DDDR+consistent atrial pacing mode, each for an 8-week study period. The efficacy of consistent atrial pacing was assessed by the number of automatic mode switching and the number of premature atrial complexes. Symptoms and quality of life were assessed by the SF-36 quality of life questionnaire and an atrial fibrillation symptom checklist. The percentage of atrial pacing increased from 57±32% to 86±28%. Overall, there was no significant difference in the number of automatic mode switching episodes between DDDR and DDDR+ consistent atrial pacing (47±90 vs 42±87, P> 0·05), but a significant reduction in premature atrial complexes by 74·7% (P< 0·001). There was no undue increase in atrial rate by the DDDR+consistent atrial pacing mode versus DDDR (63±13 vs 70±7bpm). There was no significant difference in quality of life scores and symptom severity on frequency between the two modes of pacing, but a trend towards a lower frequency of symptoms in the DDDR+consistent atrial pacing mode compared with baseline (29·5±10·2 vs 25·1±9·7, P=0·07). An algorithm that provides consistent atrial overdrive pacing can suppress atrial fibrillation triggering premature atrial complexes without the need to increase the overall atrial rate compared with conventional pacing. The algorithm appears to be well-tolerated, but further studies are needed to address the clinical impact of this atrial fibrillation prevention algorithm. © 2000 The European Society of Cardiology.en_HK
dc.languageengen_HK
dc.publisherOxford University Press. The Journal's web site is located at http://europace.oxfordjournals.org/en_HK
dc.relation.ispartofEuropaceen_HK
dc.rightsEuropace. Copyright © Oxford University Press.en_HK
dc.subject.meshAgeden_HK
dc.subject.meshAtrial Fibrillation - diagnosis - therapyen_HK
dc.subject.meshCardiac Pacing, Artificial - methodsen_HK
dc.subject.meshDefibrillators, Implantableen_HK
dc.subject.meshEchocardiography - methodsen_HK
dc.subject.meshElectrocardiography, Ambulatory - methodsen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshFollow-Up Studiesen_HK
dc.subject.meshHumansen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshQuality of Lifeen_HK
dc.subject.meshSeverity of Illness Indexen_HK
dc.subject.meshTreatment Outcomeen_HK
dc.titleEfficacy and tolerability of continuous overdrive atrial pacing in atrial fibrillationen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1099-5129&volume=29&issue=4&spage=286&epage=291&date=2000&atitle=Efficacy+and+tolerability+of+continuous+overdrive+atrial+pacing+in+atrial+fibrillationen_HK
dc.identifier.emailTse, HF:hftse@hkucc.hku.hken_HK
dc.identifier.authorityTse, HF=rp00428en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1053/eupc.2000.0124en_HK
dc.identifier.pmid11194594en_HK
dc.identifier.scopuseid_2-s2.0-0034304856en_HK
dc.identifier.hkuros57042en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0034304856&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume2en_HK
dc.identifier.issue4en_HK
dc.identifier.spage286en_HK
dc.identifier.epage291en_HK
dc.identifier.isiWOS:000166656000004-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridLam, CTF=7402990956en_HK
dc.identifier.scopusauthoridLau, CP=35275317200en_HK
dc.identifier.scopusauthoridLeung, SK=7202044902en_HK
dc.identifier.scopusauthoridTse, HF=7006070805en_HK
dc.identifier.scopusauthoridLee, KLF=8624893900en_HK
dc.identifier.scopusauthoridTang, MO=7401973887en_HK
dc.identifier.scopusauthoridTsang, V=7005694255en_HK

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