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November 7, 2011Journal of Cardiovascular ElectrophysiologyOpen Access

Atrial Dysfunction and Interatrial Dyssynchrony Predict Atrial High Rate Episodes: Insight into the Distinct Effects of Right Atrial Appendage Pacing

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Why the study?

Does a high burden of right atrial appendage pacing induce atrial dyssynchrony and predict atrial high rate episodes in patients with symptomatic bradycardia?

Population

110 patients implanted with dual-chamber pacemakers for symptomatic bradycardia, mean age 70.5 ± 11 years…

Comparison

High cumulative percentage of right atrial… vs Low cumulative percentage of right atrial…

Design

Cohort

Follow-up

1 year

Authors

JXJun‐Min XieFFFang FangQZQing Zhang

Discussion

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Overview

High right atrial appendage pacing burden was associated with dyssynchrony and AHREs; hypothesis-generating, requires randomized confirmation before practice change.

Structured PICO

Does a high burden of right atrial appendage pacing induce atrial dyssynchrony and predict atrial high rate episodes in patients with symptomatic bradycardia?

P
Population
110 patients implanted with dual-chamber pacemakers for symptomatic bradycardia, mean age 70.5 ± 11 years, 53 males.
I
Intervention
High cumulative percentage of right atrial appendage pacing (Cum%AP > 75%) over 1 year
C
Comparator
Low cumulative percentage of right atrial appendage pacing (Cum%AP < 25%)
O
Outcome
Atrial high rate episodes (AHREs) and atrial conduction time/dyssynchrony at 1-year follow-upsurrogate

A high burden of right atrial appendage pacing induces atrial dyssynchrony, and reduced atrial pump function strongly predicts the occurrence of atrial high rate episodes within the first year.

Cite This Study

Xie et al. (2011) studied this question.

synapsesocial.com/papers/6a703fc7e36a167817e2007fhttps://doi.org/10.1111/j.1540-8167.2011.02210.x
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Adverse Effect of Ventricular Pacing on Heart Failure and Atrial Fibrillation Among Patients With Normal Baseline QRS Duration in a Clinical Trial of Pacemaker Therapy for Sinus Node Dysfunction2003 · 1,792 citations
  2. 2Clinical Utility of Intraatrial Pacemaker Stored Electrograms to Diagnose Atrial Fibrillation and Flutter2001 · 155 citations
  3. 3Differences in Tachyarrhythmia Detection and Implantable Cardioverter Defibrillator Therapy by Primary or Secondary Prevention Indication in Cardiac Resynchronization Therapy Patients2004 · 835 citations
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  5. 5Interatrial dyssynchrony on tissue Doppler imaging predicts progression to chronic atrial fibrillation in patients with non-valvular paroxysmal atrial fibrillation2009 · 32 citations