Dual chamber pacemaker implantation during atrial fibrillation in patients with PAF

We report follow-up data on 11 patients with bradycardia and paroxysmal atrial fibrillation (PAF) who received dual chamber pacemakers during an episode of PAF. Implants were carried out between February 1999 and May 2000. All patients had a conventional indication for pacing. 10 patients had previously documented episodes of PAF. 6 patients were in AF and 4 in atrial flutter prior to implant. 1 patient developed AF during the procedure before atrial pacing parameters could be measured. In all cases the atrial lead position was accepted solely on the X-ray appearances provided satisfactory sensing of fibrillation or flutter could be achieved. Following pacing, spontaneous cardioversion to sinus rhythm occurred in 4 patients within 24 hours and in 1 patient within 7 days. 5 patients underwent successful DC cardioversion after stabilisation on anticoagulant treatment. 1 patient has remained in flutter/fibrillation since implantation, in 10 patients, satisfactory atrial pacing and sensing parameters have been measured in the pacemaker clinic on at least one occasion. To date. follow-up data are available on all 11 patients for 0-4 months after successful cardioversion to sinus or atrial paced rhythm (average 2 months). At the most recent review, 9 patients were in sinus or atrial paced rhythm, 2 apparently in permanent AF.