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Atrial Septal Pacing:
Author(s) -
PADELETTI LUIGI,
MICHELUCCI ANTONIO,
PIERAGNOLI PAOLO,
COLELLA ANDREA,
MUSILLI NICOLA
Publication year - 2004
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 - 10.1111/j.1540-8159.2004.00546.x
Subject(s) - medicine , cardiology , atrial fibrillation , bradycardia , refractory period , coronary sinus , repolarization , p wave , anesthesia , heart rate , electrophysiology , blood pressure
Atrial pacing may prevent the onset of atrial fibrillation (AF) because of: (1) prevention of the relative bradycardia that triggers paroxysmal AF; (2) prevention of the bradycardia induced dispersion of refractoriness; (3)suppression or reduction of premature atrial contractions that initiate reentry and predispose to AF; (4) preservation of AV synchrony, which might prevent switch induced changes in atrial repolarization predisposing to AF. Atrial pacing locations that decrease atrial activation and dispersion of refractoriness may be preferable in patients with a history of AF. Two different interatrial septum sites have been proposed: the Bachmann's bundle and the coronary sinus ostium. The results of two prospective randomized studies indicate that septal pacing, when compared to the traditional right atrial appendage pacing, significantly reduces : (1) paroxysmal AF recurrences and burden; and (2) progression to chronic AF. (PACE 2004; 27[Pt. II]:850–854)