Objective To investigate the effects of atrial septal pacing (ASP) on the attack of paroxysmal atrial fibrillation (PAF) in patients with sick sinus syndrome (SSS).
Methods ASP was performed in 12 patients of PAF with SSS, in whom DDD pacemaker was implanted. In all patients, 24 h dynamic electrocardiogram, 12-lead surface electrocardiogram and two-dimensional echocardiography were checked for observing episode cases, frequencies and persistence time of PAF, measuring P wave duration maximum (Pmax) and dispersion (Pd), and detecting atrium diameter, respectively, at preoperation and postoperation 1-week, 3-month and 1-year, respectively.
Results The Pmax was shorter and Pd was smaller significantly during ASP at postoperation 1-week, 3-month and 1-year than those during sinus rhythm before pacing (all p<0.05). As compared with those before pacing, the episode cases, frequencies and persistence time of the PAF were significantly reduced at postoperation 1-week of (p<0.05), but there was a increase trend at postoperation 3-month and 1-year. The recurrence of PAF after ASP was mostly relation to enlarged left atrium and existence of basic heart disease, but not associated with pacing ratio. The left atrium dimension was slightly smaller after ASP than preoperation (p>0.05).
Conclusions The ASP can shorten Pmax, minish Pd and prevent from recurrence of PAF, but the long-term efficacy of the latter is poor possibly in patients with enlarged left atrium and existence of basic heart disease