Europace Advance Access originally published online on May 21, 2009
Europace 2009 11(8):1041-1047; doi:10.1093/europace/eup115
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Pacing and CRT
Impact of atrial antitachycardia pacing and atrial pace prevention therapies on atrial fibrillation burden over long-term follow-up
1 Health Sciences Centre, Department of Cardiac Sciences, University of Calgary, Calgary Health Region, Rm. 1634, 3330 Hospital Dr. NW, Calgary, Alberta, Canada T2N 4N1; 2 Libin Cardiovascular Institute of Alberta, Calgary, Alberta, Canada
Aims: Selective atrial pacing algorithms have been developed for prevention of atrial tachycardia/atrial fibrillation (AT/AF). Although short-term studies have shown modest to minimal incremental benefit of these algorithms compared with conventional dual-chamber (DDD/R) pacing for prevention of AT/AF, the long-term effects of these algorithms are unknown. Accordingly, we compared atrial antitachycardia pacing (ATP) therapy and combined atrial ATP and atrial pace prevention (ATP + Prevention) algorithms to conventional DDD/R pacing for prevention of AT/AF over long-term follow-up.
Methods and results: Seventy-one patients with AT/AF following pacemaker insertion were randomized to DDD/R pacing, DDD/R plus ATP pacing, or DDD/R plus ATP and prevention pacing and followed for 3 years. Atrial tachycardia/AF burden and an AF symptom scale were compared over time between groups. Atrial tachycardia/AF burden remained stable over 3 years in the DDD/R and ATP + Prevention groups. Atrial tachycardia/AF burden increased significantly over time in the ATP group. Patients not on class I or III antiarrhythmic drug therapy were more likely to experience an increase in AT/AF burden over time.
Conclusion: Atrial ATP and atrial ATP in combination with atrial pace prevention algorithms do not suppress AT/AF over long-term follow-up compared with DDD/R pacing.
Key Words: Atrial fibrillation, Atrial pacing algorithms, Dual-chamber pacing, Antitachycardia pacing
* Corresponding author. Tel: +1 403 220 6841, Fax: +1 403 270 0313, Email: amgillis{at}ucalgary.ca
Manuscript submitted 9 January 2009. Accepted after revision 16 April 2009.
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- Atrial antitachycardia pacing: do we still need to talk about it?
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Europace 2009 11: 977-979.[Full Text]
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  S. Janko and E. Hoffmann Atrial antitachycardia pacing: do we still need to talk about it? Europace, August 1, 2009; 11(8): 977 - 979. [Full Text] [PDF]
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