Does chronic atrial pacing prevent intra-atrial reentry tachycardia in patients with sinus node dysfunction?
Chronic atrial pacing can effectively prevent intra-atrial reentry tachycardia associated with sinus node dysfunction, potentially eliminating the need for antiarrhythmic drugs.
The authors describe a case of so-called "intra-atrial reentry," associated with sinus node dysfunction. The spontaneous initiation of the tachycardia was always preceded by a sinus pause, and external atrial pacing prevented the appearance of tachycardia. Thus an atrial pacemaker was implanted, and after several months, the atrial dysrhythmias disappeared completely, despite interruption of the antiarrhythmic drugs. When a pacemaker dysfunction occurred, the sinus node dysfunction and the tachycardia reappeared. This is analogous with the "incessant" tachycardias seen in the WPW syndrome, and must be differentiated from the usual forms of the sick sinus syndrome which require both a pacemaker and antiarrhythmic drugs.
Leclercq et al. (Sat,) studied this question.