Premium
Acute Effects of Different Atrial Pacing Sites in Patients with Atrial Fibrillation: Comparison of Single Site and Biatrial Pacing
Author(s) -
OGAWA MASAHIRO,
SUYAMA KAZUHIRO,
KURITA TAKASHI,
SHIMIZU WATARU,
MATSUO KIYOTAKA,
TAGUCHI ATSUSHI,
AIHARA NAOHIKO,
KAMAKURA SHIRO,
SHIMOMURA KATSURO
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.1460-9592.2001.01470.x
Subject(s) - medicine , coronary sinus , atrial fibrillation , cardiology , refractory period , electrophysiology , effective refractory period , atrium (architecture) , refractory (planetary science) , anesthesia , physics , astrobiology
Ogawa, M., et al. : Acute Effects of Different Atrial Pacing Sites in Patients with Atrial Fibrillation: Comparison of Single site and Biabrial Pacing. It has been reported that atrial single site or biatrial pacing can suppress the occurrence of AF. However, its mechanism remains unclear. The study population included 32 patients with AF ( n = 20: AF group ), or without paroxysmal AF ( n = 12: control group ). The mechanism and efficacy of atrial pacing were investigated by electrophysiological studies to determine which was more effective for suppressing AF induction; single site pacing of the right atrial appendage (RAA) or distal coronary sinus (CS–d), or biatrial (simultaneous RAA and CS–d) pacing. In the AF group, AF inducibility was significantly higher with RAA extrastimulus during RAA ( 12/20; P < 0.0001 ) or biatrial paced drive ( 7/20; P < 0.01 ) than during CS–d paced drive (0/20). In the control group, AF was not induced at any site paced. In the AF group, the conduction delay and other parameters of atrial vulnerability significantly improved during CS–d paced drive. The atrial recovery time (ART) at RAA and CS–d was measured during each basic pacing mode. ART was defined as the sum of the activation time and refractory period, and the difference between ARTs at RAA and CS–d was calculated as the ART difference (ARTD). The ARTD was significantly longer during RAA pacing in the AF group than in control group ( 155.0 ± 32.8 vs 128.8 ± 32.9 ms, P < 0.05 ). In the AF group, ARTDs during biatrial ( 52.0 ± 24.2 ms ) and CS–d pacing ( 51.7 ± 26.0 ms ) were significantly shorter than ARTD during RAA pacing. The CS–d paced drive was more effective for suppressing AF induction than biatrial or RAA paced drive by alleviating conduction delay. CS–d and biatrial pacing significantly reduced ARTD compared with RAA pacing.