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The Effect of the Atrial Pacing Site on the Total Atrial Activation Time
Author(s) -
ROITHINGER FRANZ X.,
ABOUHARB MARIA,
PACHINGER OTMAR,
HINTRINGER FLORIAN
Publication year - 2001
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1046/j.1460-9592.2001.00316.x
Subject(s) - medicine , coronary sinus , cardiology , atrial fibrillation , atrium (architecture) , interatrial septum , ostium , p wave , sinus rhythm , anesthesia , left atrium
ROITHINGER, F.X., et al. : The Effect of the Atrial Pacing Site on the Total Atrial Activation Time. The effect of dual site pacing for prevention of atrial fibrillation may be due to synchronization of right and left atrial activation. Little is known, however, about the effect of pacing from single right atrial sites on differences in interatrial conduction. Twenty‐eight patients without structural heart disease were studied following radiofrequency catheter ablation of supraventricular arrhythmias. Pacing was performed using standard multipolar catheters from the presumed insertion site of Bachmann's bundle, the coronary sinus ostium, the high lateral right atrium, and the right atrial appendage ( n = 8 patients ). Bipolar recording was performed from the distal coronary sinus, the high and low lateral right atrium, and the posterolateral left atrium ( n = 13 patients ). The longest conduction time from each pacing to each recording site was considered the total atrial activation time for the respective pacing site. During high right atrial pacing, the total atrial activation time was determined by the conduction to the distal coronary sinus ( 118 ± 18 ms ), during coronary sinus ostium pacing by the conduction to the high right atrium ( 94 ± 18 ms ), and during Bachmann's bundle pacing by the conduction to the distal coronary sinus ( 74 ± 18 ms ). The total atrial activation time was signifiantly shorter during pacing from Bachmann's bundle, as compared to pacing from other right atrial sites. Thus, in normal atria, pacing from the insertion of Bachmann's bundle causes a shorter total atrial activation time and less interatrial conduction delay, as compared to pacing from other right atrial sites. These findings may have implications for alternative pacing sites for prevention of atrial fibrillation.