Key result
A dual-stage atrial septal pacing algorithm increased the mean success rate of atrial fibrillation termination to 20.2% compared to 10.2% with rapid septal pacing alone in a biophysical model.
Why the study?
Does a dual-stage atrial septal pacing algorithm improve the termination of atrial fibrillation compared to rapid pacing alone in a biophysical model of human atria?
Does a dual-stage atrial septal pacing algorithm improve the termination of atrial fibrillation compared to rapid pacing alone in a biophysical model of human atria?
Absolute Event Rate: 20.2% vs 10.2%
A novel dual-stage atrial septal pacing algorithm showed promise in terminating atrial fibrillation in a biophysical model, suggesting a potential new pacing strategy that requires experimental validation.
May enhance modeled AF termination; hypothesis-generating and requires in vivo validation before clinical testing.
AIMS: While successful termination by pacing of organized atrial tachycardias has been observed in patients, single site rapid pacing has not yet led to conclusive results for the termination of atrial fibrillation (AF). The purpose of this study was to evaluate a novel atrial septal pacing algorithm for the termination of AF in a biophysical model of the human atria. METHODS AND RESULTS: Sustained AF was generated in a model based on human magnetic resonance images and membrane kinetics. Rapid pacing was applied from the septal area following a dual-stage scheme: (i) rapid pacing for 10-30 s at pacing intervals 62-70% of AF cycle length (AFCL), (ii) slow pacing for 1.5 s at 180% AFCL, initiated by a single stimulus at 130% AFCL. Atrial fibrillation termination success rates were computed. A mean success rate for AF termination of 10.2% was obtained for rapid septal pacing only. The addition of the slow pacing phase increased this rate to 20.2%. At an optimal pacing cycle length (64% AFCL) up to 29% of AF termination was observed. CONCLUSION: The proposed septal pacing algorithm could suppress AF reentries in a more robust way than classical single site rapid pacing. Experimental studies are now needed to determine whether similar termination mechanisms and rates can be observed in animals or humans, and in which types of AF this pacing strategy might be most effective.
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Uldry et al. (2012) studied Atrial fibrillation. Dual-stage atrial septal pacing algorithm vs. Rapid septal pacing only was evaluated on Atrial fibrillation termination success rate. A dual-stage atrial septal pacing algorithm increased the mean success rate of atrial fibrillation termination to 20.2% compared to 10.2% with rapid septal pacing alone in a biophysical model.
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