What does this research mean for the field?

Acute dual-site right atrial pacing suppresses inducible atrial fibrillation or flutter in over half of susceptible patients, with efficacy correlating with greater dispersion of right atrial refractoriness between pacing sites. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate whether dual-site right atrial pacing prevents induced atrial fibrillation or flutter and identify electrophysiological mechanisms linked to antiarrhythmic success.

August 17, 2026Journal of the American College of CardiologyOpen Access

Acute Effects of Dual-Site Right Atrial Pacing in Patients With Spontaneous and Inducible Atrial Flutter and Fibrillation

Q: What is the clinical evidence from this study?

Population: Symptomatic atrial fibrillation or atrial flutter (n=20). Intervention: Dual-site right atrial pacing vs. Single-site high right atrial pacing. Primary outcome: Suppression of inducible atrial fibrillation or atrial flutter.

View Full Paper

Ask AI

Bookmark

Key result

Acute dual-site right atrial pacing suppresses inducible AF or flutter in 56% of patients.

n=20

Why the study?

Long-term dual-site right atrial pacing prevents recurrent AF, but the mechanism of antiarrhythmic benefit remains unclear.

Does dual-site right atrial pacing suppress inducible atrial fibrillation or atrial flutter compared to single-site pacing in patients with symptomatic AF or atrial flutter?

Key Points

To evaluate whether dual-site right atrial pacing prevents induced atrial fibrillation or flutter and identify electrophysiological mechanisms linked to antiarrhythmic success.
Studied 20 patients (mean age 64 ± 16 years; 10 with atrial fibrillation, 10 with atrial flutter) undergoing programmed atrial stimulation at drive cycle lengths of 600 ms and 400 ms with atrial extrastimuli.
Delivered simultaneous dual-site pacing at the high right atrium and coronary sinus ostium to test acute arrhythmia reinduction against single-site pacing.
Dual-site pacing significantly reduced P-wave duration to 103 ± 17 ms compared to sinus rhythm (120 ± 12 ms, p = 0.005) and single-site high right atrial pacing (121 ± 17 ms, p = 0.005).
Among 16 patients with inducible arrhythmias, dual-site pacing acutely suppressed tachyarrhythmias in 9 patients (56%), including 5 with atrial fibrillation and 4 with atrial flutter.
Patients with successful suppression demonstrated a significantly greater difference in effective refractory period between pacing sites than non-responders (33 ± 12 ms vs 15 ± 13 ms, p = 0.001).

Structured PICO

Does dual-site right atrial pacing suppress inducible atrial fibrillation or atrial flutter compared to single-site pacing in patients with symptomatic AF or atrial flutter?

Population

20 patients (mean age 64 years, 50% female) with symptomatic atrial fibrillation or atrial flutter undergoing acute electrophysiologic testing.

Intervention

Dual-site right atrial pacing (simultaneously pacing at the high right atrium and coronary sinus ostium).

Comparator

Single-site high right atrial pacing and sinus rhythm.

Outcome

Suppression of induced atrial tachyarrhythmia (atrial fibrillation or atrial flutter).surrogate

Discussion

No takes yet. Share an insight, caveat, or question.

Implication

Dual-site right atrial pacing can acutely suppress inducible atrial fibrillation or flutter in selected patients, particularly those with greater dispersion of right atrial refractoriness.

Cite This Study

Prakash et al. (1997) studied Symptomatic atrial fibrillation or atrial flutter (n=20). Dual-site right atrial pacing vs. Single-site high right atrial pacing was evaluated on Suppression of inducible atrial fibrillation or atrial flutter. Acute dual-site right atrial pacing suppressed inducible atrial fibrillation or flutter in 56% of tested patients, with success correlating with greater dispersion of right atrial refractoriness.

synapsesocial.com/papers/6a837ac2ec361eff96a61a1c https://doi.org/10.1016/s0735-1097(97)00043-0

Topics

Atrial fibrillation Persistent AF management

View Full Paper

Ask AI

Bookmark

Implication

Dual-site right atrial pacing can acutely suppress inducible atrial fibrillation or flutter in selected patients, particularly those with greater dispersion of right atrial refractoriness.

Acute Effects of Dual-Site Right Atrial Pacing in Patients With Spontaneous and Inducible Atrial Flutter and Fibrillation

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Topics

Acute Effects of Dual-Site Right Atrial Pacing in Patients With Spontaneous and Inducible Atrial Flutter and Fibrillation

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider