January 1, 2002Circulation JournalOpen Access

Evaluation of Bi-Atrial Pacing and Single Site Right Atrial Pacing for the Prevention of Atrial Fibrillation

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Why the study?

Does bi-atrial pacing reduce atrial fibrillation episodes in patients with sick sinus syndrome and paroxysmal AF compared to single site right atrial pacing?

Structured PICO

Does bi-atrial pacing reduce atrial fibrillation episodes in patients with sick sinus syndrome and paroxysmal AF compared to single site right atrial pacing?

Population

6 patients with sick sinus syndrome and paroxysmal atrial fibrillation

Intervention

Bi-atrial pacing (BAP)

Comparator

Single site right atrial pacing (RAP) and control

Outcome

Number of atrial fibrillation (AF) episodes

Both bi-atrial pacing and right atrial pacing reduce AF episodes compared to control in patients with sick sinus syndrome, but bi-atrial pacing does not offer additional benefit over right atrial pacing for AF prevention.

Implication

Atrial pacing may reduce AF episodes in sick sinus syndrome; leaves open any added benefit of bi-atrial over right atrial pacing.

Abstract

Atrial resynchronization resulting from simultaneous pacing of the atria may adjust inter- or intra-atrial asynchrony and prevent atrial fibrillation (AF). The purpose of this study was to assess the efficacy of bi-atrial pacing (BAP) in preventing AF, and the safety of this system. The effect of BAP was compared with single site right atrial pacing (RAP) in 6 patients with sick sinus syndrome and paroxysmal AF in a prospective switchover trial. P wave duration was significantly reduced during BAP (p<0.01). Pacing threshold, atrial wave amplitude and the lead impedance presented no significant differences at implant, 1 week and 3 months after implantation, respectively (NS). The number of AF episodes significantly decreased during both RAP and BAP compared with the control (p<0.01). Although the number of premature atrial contractions was significantly less during BAP than RAP (p<0.05), there were no significant differences of AF episodes between the two. The percentage of pacing was achieved in only 70% during both pacing modes. BAP was safe and reliable in this follow-up period and can prevent AF. These findings provide encouragement for further study and observation of BAP to prevent AF.