TY - JOUR
T1 - Prevention of short term reversible chronic atrial fibrillation by permanent pacing at the triangle of Koch
AU - Padeletti, Luigi
AU - Porciani, Maria Cristina
AU - Michelucci, Antonio
AU - Colella, Andrea
AU - Costoli, Alessandro
AU - Ciapetti, Cristina
AU - Pieragnoli, Paolo
AU - Musilli, Nicola
AU - Gensini, Gian Franco
PY - 2000
Y1 - 2000
N2 - Objectives: The purpose of this study was to investigate if single lead interatrial septum pacing could be effective in maintaining sinus rhythm in patients in whom restoration of sinus rhythm was only possible for a period of 2-24 hours after one or more previous electrical cardioversions, and in whom a sinus bradycardia was documented before arrhythmia restarted. The two hours limit was chosen because it was considered a sufficient time to implant a dual chamber pacemaker. Background: Alternative atrial pacing techniques have been demonstrated to be successful in preventing recurrences of atrial fibrillation (AF) in patients with sinus bradycardia. Excluding the AF occurring after only a few sinus beats, at 24 hours from electrical cardioversion an early restart of chronic AF has been reported in 12% to 17% of the patients. Methods: After sinus rhythm was restored by internal electrical cardioversion, 17 patients, 7 ablated at the AV junction, underwent a dual chamber rate response (DDDR) pacemaker implantation with a screw-in atrial lead placed in the interatrial septum. Results: After a follow-up period of 17 ± 5 months (range 12 to 27 months) persistence of sinus rhythm was observed in 11 patients (65%). Six patients (35%) had recurrences of paroxysmal attacks, while five (30%) were totally free of AF. Recurrence of chronic AF was observed in six cases (35%) after 2 days-12 months from implantation. No dislodgements of the atrial lead and no complications were observed at implantation and during follow-up. Conclusions: Interatrial septum pacing is a safe and feasible technique with a satisfying success rate (65%) in long-term maintaining sinus rhythm in previously unsuccessfully cardioverted patients.
AB - Objectives: The purpose of this study was to investigate if single lead interatrial septum pacing could be effective in maintaining sinus rhythm in patients in whom restoration of sinus rhythm was only possible for a period of 2-24 hours after one or more previous electrical cardioversions, and in whom a sinus bradycardia was documented before arrhythmia restarted. The two hours limit was chosen because it was considered a sufficient time to implant a dual chamber pacemaker. Background: Alternative atrial pacing techniques have been demonstrated to be successful in preventing recurrences of atrial fibrillation (AF) in patients with sinus bradycardia. Excluding the AF occurring after only a few sinus beats, at 24 hours from electrical cardioversion an early restart of chronic AF has been reported in 12% to 17% of the patients. Methods: After sinus rhythm was restored by internal electrical cardioversion, 17 patients, 7 ablated at the AV junction, underwent a dual chamber rate response (DDDR) pacemaker implantation with a screw-in atrial lead placed in the interatrial septum. Results: After a follow-up period of 17 ± 5 months (range 12 to 27 months) persistence of sinus rhythm was observed in 11 patients (65%). Six patients (35%) had recurrences of paroxysmal attacks, while five (30%) were totally free of AF. Recurrence of chronic AF was observed in six cases (35%) after 2 days-12 months from implantation. No dislodgements of the atrial lead and no complications were observed at implantation and during follow-up. Conclusions: Interatrial septum pacing is a safe and feasible technique with a satisfying success rate (65%) in long-term maintaining sinus rhythm in previously unsuccessfully cardioverted patients.
KW - Atrial fibrillation
KW - Atrial pacing
KW - Electrical cardioversion
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U2 - 10.1023/A:1026557313240
DO - 10.1023/A:1026557313240
M3 - Article
C2 - 11141202
AN - SCOPUS:0034507889
VL - 4
SP - 575
EP - 583
JO - Journal of Interventional Cardiac Electrophysiology
JF - Journal of Interventional Cardiac Electrophysiology
SN - 1383-875X
IS - 4
ER -