Key result
Right atrial linear lesions did not reduce mean atrial tachyarrhythmia burden compared to no lesions (202 vs 84 min/day), but interatrial septum pacing was superior to appendage pacing (P<0.016).
Why the study?
Does the addition of right atrial linear lesions (RALL) to atrial pacing and antiarrhythmic drug therapy reduce atrial tachyarrhythmia burden in patients with paroxysmal AF and sinus bradycardia?
RCT (n=64)
Randomized
Does the addition of right atrial linear lesions (RALL) to atrial pacing and antiarrhythmic drug therapy reduce atrial tachyarrhythmia burden in patients with paroxysmal AF and sinus bradycardia?
Absolute Event Rate: 202% vs 84%
Right atrial linear lesions do not provide additional benefit to combined antiarrhythmic drug therapy and atrial pacing for reducing atrial tachyarrhythmia burden in patients with sinus bradycardia and paroxysmal AF, though interatrial septum pacing appears superior to right atrial appendage pacing.
No takes yet. Share an insight, caveat, or question.
Right atrial linear lesions add no benefit to pacing plus antiarrhythmic drugs; challenges substrate modification while supporting septal over appendage pacing.
Padeletti et al. (2003) conducted an RCT in Symptomatic paroxysmal AF and sinus bradycardia requiring permanent atrial pacing (n=64). Right atrial linear lesions (RALL) vs. Non-right atrial linear lesions (NRALL) was evaluated on Mean atrial tachyarrhythmia (AT) burden. Right atrial linear lesions did not reduce mean atrial tachyarrhythmia burden compared to no lesions (202 vs 84 min/day), but interatrial septum pacing was superior to appendage pacing (P<0.016).
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