Biatrial pacing significantly increased cardiac output (4.9 vs 4.1 l/min) and reduced pulmonary capillary wedge pressure (11.0 vs 12.9 mmHg) compared to right atrial appendage pacing in patients with interatrial block.
RCT (n=28)
Single-blind
Randomized cross-over
No
Does biatrial pacing improve cardiac hemodynamics and reduce inflammatory markers compared to right atrial appendage pacing in patients with interatrial block?
Biatrial pacing improves hemodynamic performance and reduces markers of inflammation and atrial stretch compared to conventional right atrial appendage pacing in patients with interatrial block.
Absolute Event Rate: 4.9% vs 4.1%
p-value: p=0.02
PURPOSE: Interatrial block (IAB) frequently coexists with sinus node disease and is considered a risk factor of left atrial dysfunction, atrial arrhythmias, and heart failure development. Conventional right atrial appendage (RAA) pacing impairs intra- and interatrial conductions and consequently prolongs P wave duration. Biatrial (BiA) pacing helps correct IAB, but its advantageous influence remains controversial. The aim of the study was to compare the effects of BiA and RAA pacing on cardiac hemodynamics and serum concentrations of inflammatory markers and neuropeptides. METHODS: Twenty-eight patients with IAB and preserved atrio-ventricular conduction treated with BiA pacing were studied. Standard invasive hemodynamic measurements were performed during BiA and RAA pacings. Furthermore, the influence of 1 week of BiA and RAA pacing on neuropeptides: atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) and markers of inflammation: high sensitivity C-reactive protein (hs-CRP), interleukin 6 (IL-6), and neopterin was examined. RESULTS: BiA pacing resulted in significant increase of cardiac output (CO) and reduction of pulmonary capillary wedge pressure. We demonstrated significantly lower concentrations of ANP, hs-CRP, IL-6, and neopterin after 1 week of BiA in comparison to RAA pacing. BNP levels remained unchanged. CONCLUSIONS: BiA pacing in comparison to RAA pacing improves hemodynamic performance in patients with IAB and preserved atrio-ventricular conduction. BiA pacing is associated with reduction of ANP and markers of inflammation (hs-CRP, IL-6, and neopterin).
Rubaj et al. (Sun,) conducted a rct in Interatrial block with preserved atrio-ventricular conduction (n=28). Biatrial pacing vs. Right atrial appendage pacing was evaluated on Cardiac output (l/min) (p=0.02). Biatrial pacing significantly increased cardiac output (4.9 vs 4.1 l/min) and reduced pulmonary capillary wedge pressure (11.0 vs 12.9 mmHg) compared to right atrial appendage pacing in patients with interatrial block.