Why the study?
Does septal pacing reduce AF recurrences and progression to chronic AF compared to traditional right atrial appendage pacing in patients with a history of AF?
Does septal pacing reduce AF recurrences and progression to chronic AF compared to traditional right atrial appendage pacing in patients with a history of AF?
Septal pacing may be superior to traditional right atrial appendage pacing in reducing AF recurrences and progression in patients with a history of AF.
Supports septal pacing investigation in AF patients; Level 5 evidence leaves randomized confirmation open before practice change.
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.
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Padeletti et al. (2004) studied this question.
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