ElectrophysiologyRandomized crossover comparison of right atrial appendage pacing versus interatrial septum pacing for prevention of paroxysmal atrial fibrillation in patients with sinus bradycardia☆
Section snippets
Study population
Forty-six patients (18 male, 28 female, mean age 74 ± 12 years) with a history of sinus bradycardia and PAF who had had at least 2 episodes per month of symptomatic PAF within 3 months before study were enrolled. At least one of these episodes was documented electrocardiographically. No patients had atrial linear or atrioventricular node ablation before or during the trial. The study was approved by the institutional review board, and witnessed informed consent was obtained from each patient.
Study protocol
Study population
Twenty-two patients (11 male, 11 female, 76 ± 6 years old) were randomized to the IASP group and 24 (7 male, 17 female, 74 ± 10 years old) to the RAAP group. The clinical characteristics of the 2 groups were similar and are shown in Table I.Empty Cell IASP (n = 22) RAAP (n = 24) Age (y) 76 ± 6 74 ± 10 Female (%) 11 (50) 17 (71) Symptomatic PAF episodes/mo 5.4 ± 7.1 6.0 ± 10.1 Heart disease None 5 (23) 7 (29) Hypertension 9 (41) 6 (25) Coronary artery disease 10 (45) 12 (50) Valvular heart
Pacing and prevention of AF
Becker et al16 studied the effects of single-, dual-, triple-, and quadruple-site atrial pacing on atrial activation and refractoriness in normal canine hearts. Single-site septal, triple-site (2 in the right atrium and 1 in the left atrium) and quadruple-site (2 in the right atrium and 2 in the left atrium) pacing was similar and was more efficient than biatrial and dual-site right atrial pacing in minimizing activation times and local recovery intervals.
Yu et al17 showed that in patients with
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Association between sick sinus syndrome and atrial fibrillation: A systematic review and meta-analysis
2023, International Journal of CardiologyImplication of ventricular pacing burden and atrial pacing therapies on the progression of atrial fibrillation: A systematic review and meta-analysis of randomized controlled trials
2019, Heart RhythmCitation Excerpt :All the studies were RCT with appropriate study methodology. Twelve studies were crossover trials,8,9,12,14–20,23 whereas 13 studies were parallel trials.3–7,10,11,13,21,22 Most trials were single-blinded, 1 was double-blinded,10 and 9 studies did not mention the blinding method.
Current Concepts of Anatomy, Electrophysiology, and Therapeutic Implications of the Interatrial Septum
2019, JACC: Clinical ElectrophysiologyLow interatrial septal pacing: A simple method
2017, Indian Heart JournalElectrocardiographic features: Various atrial site pacing
2017, Indian Heart JournalInteratrial septal pacing to suppress atrial fibrillation in patients with dual chamber pacemakers: A meta-analysis of randomized, controlled trials
2016, International Journal of Cardiology
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Reprint requests: Luigi Padeletti, MD, Institute of Internal Medicine and Cardiology, University of Florence, Viale Morgagni 85, 50134 Florence, Italy. E-mail: [email protected]