Right atrial overdrive pacing for prevention of symptomatic refractory atrial fibrillation. |
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Authors: | Martin E W Hemels Ans C P Wiesfeld Bas Inberg Pascal F H M Van Dessel Wiebe Nieuwland Eng S Tan Henk Mulder Dirk J Van Veldhuisen Isabelle C Van Gelder |
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Affiliation: | Department of Cardiology, Thoraxcenter, University Medical Center Groningen, University of Groningen, The Netherlands. |
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Abstract: | AIMS: Our aim was to investigate whether right atrial overdrive pacing is effective for the prevention of atrial fibrillation (AF) in patients without bradyarrhythmias. METHODS AND RESULTS: Patients with symptomatic paroxysmal or persistent AF refractory to at least two Class I or III antiarrhythmic drugs and without bradyarrhythmias were included. Successful therapy was defined as the combination of (a) a reduction of AF burden with or without AAD use >75%, (b) total AF burden < or =5% per year, and (c) less than one electrical cardioversion per year. Lower rate was set at 70 b.p.m. Additional AF prevention and termination features were used in case of no success.After a median follow-up of 18 (10-55) months, therapy was effective in 19 of the 36 included patients (53%). In 74% of the successfully treated patients, additional antiarrhythmic drugs were used. In successfully treated patients, the AF burden was reduced from 15% (5-100%) to 0% (0-4%). Multivariate analysis showed that the concomitant use of a Class I or III antiarrhythmic drug, a lower AF burden before implantation and the use of an angiotensin converting enzyme inhibitor were predictors of successful therapy. CONCLUSION: Right atrial overdrive pacing in combination with antiarrhythmic drugs seems an attractive treatment option in drug refractory symptomatic AF patients. |
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Keywords: | Atrial fibrillation Pacing Antiarrhythmic drugs |
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