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March 1, 2000Pacing and Clinical Electrophysiology

Prevention of the Initiation of Atrial Fibrillation: Mechanism and Efficacy of Different Atrial Pacing Modes

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Key result

Bachmann's bundle, septal, and distal coronary sinus pacing yields 0% AF induction vs RAA pacing.

  • n=15

Why the study?

The relative efficacy and electrophysiological mechanisms of different atrial pacing modes in preventing atrial fibrillation are not clear.

Do different atrial pacing modes prevent the initiation of atrial fibrillation compared to right atrial appendage pacing in patients with paroxysmal AF?

Population

15 patients with paroxysmal atrial fibrillation, mean age 54 +/- 14 years

Comparison

Bachmann's bundle, right posterior interatrial septum, distal coronary sinus, DSA, and BiA pacing versus right atrial appendage pacing

Design

Electrophysiological study in patients with paroxysmal AF

Authors

WYWEN‐CHUNG YUElectrophysiologyCTCHIN‐FENG TSAINational Sun Yat-sen UniversityMHMING‐HSIUNG HSIEHWan Fang Hospital

Discussion

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Member takes

Overview

Should not yet change pacing practice; hypothesis-generating for AF prevention and requires randomized confirmation.

Structured PICO

Do different atrial pacing modes prevent the initiation of atrial fibrillation compared to right atrial appendage pacing in patients with paroxysmal AF?

P
Population
15 patients with paroxysmal atrial fibrillation undergoing electrophysiological testing with six different atrial pacing modes.
I
Intervention
Different atrial drive pacings: Bachmann's bundle (BB), right posterior interatrial septum (RPS), distal coronary sinus (DCS), right atrial appendage (RAA) plus RPS simultaneously (DSA), and RAA plus DCS simultaneously (BiA)
C
Comparator
Right atrial appendage (RAA) drive pacing
O
Outcome
Induction of atrial fibrillation with early RAA extrastimulation coupling to drive pacingsurrogate

Main Result

Absolute Event Rate: 0% vs 100%

Single-site pacing at Bachmann's bundle, right posterior interatrial septum, or distal coronary sinus is more effective than dual-site or biatrial pacing in preventing AF induction in patients with paroxysmal AF.

Cite This Study

YU et al. (2000) studied Paroxysmal atrial fibrillation (n=15). Bachmann's bundle (BB), right posterior interatrial septum (RPS), and distal coronary sinus (DCS) pacing vs. Right atrial appendage (RAA) pacing was evaluated on Induction of atrial fibrillation with early RAA extrastimulation. Bachmann's bundle, right posterior interatrial septum, and distal coronary sinus pacing completely prevented AF induction (0%) compared to right atrial appendage pacing (100%).

synapsesocial.com/papers/6aaa49c462e25fb125be02cehttps://doi.org/10.1111/j.1540-8159.2000.tb06764.x
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Also Consider

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

  1. 1Coronary Sinus Pacing Prevents Induction of Atrial Fibrillation1997 · 129 citations
  2. 2DDD Pacing: An Effective Treatment Modality for Recurrent Atrial Arrhythmias1988 · 108 citations
  3. 3<b>Atrial Septal Pacing:</b> A Method for Pacing Both Atria Simuhaneously1997 · 69 citations
  4. 4Chronic atrial fibrillation and stroke in paced patients with sick sinus syndrome. Relevance of clinical characteristics and pacing modalities.1993 · 205 citations
  5. 5Site-Dependent Intra-Atrial Conduction Delay1996 · 235 citations