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Europace 2005 7(2):170-174; doi:10.1016/j.eupc.2004.12.006
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© 2005 The European Society of Cardiology. Published by Elsevier Ltd. All rights reserved.

Right atrial overdrive pacing does not prevent atrial fibrillation after coronary artery bypass surgery

Tapio Hakalaa,*, Antti J.M. Valtolaa, Anu K. Turpeinenb, Antti E. Hedmanb, Rauli E.U. Vuorenniemia, Jari M. Karjalainena, Ismo S. Vajantoa, Juhani Kouria, Pekka A. Jaakkolaa and Juha E.K. Hartikainenb

aDepartment of Surgery, Kuopio University Hospital P.O. Box 1777, FIN-70211 Kuopio, Finland; bDepartment of Internal Medicine, Kuopio University Hospital P.O. Box 1777, FIN-70211 Kuopio, Finland

AIMS: The purpose of this prospective randomized study was to investigate the efficacy of atrial overdrive pacing (AOP) and bradycardia prevention pacing (BPP) in the prophylaxis of atrial fibrillation (AF) after coronary artery bypass surgery (CABG).

METHODS: One hundred and twenty-four on-pump CABG patients were randomized into three groups: AOP, BPP, and NP (no pacing). AOP patients were paced via epicardial wires using an atrial preference pacing algorithm, and BPP patients were paced in the AAI mode with a base rate of 60/min. Patients were paced for 48 h starting on the first postoperative day. The endpoint of the study was the first onset of AF lasting longer than 5 min.

RESULTS: Preoperative risk factors and surgical data of patients did not differ between the AOP, BPP and NP groups. Pacing was technically successful in 80.5% of patients in the AOP and in 92.7% in the BPP groups. The incidence of AF in the AOP (26.8%), BPP (19.5%) and NP (28.6%) groups did not differ significantly. In the AOP group, AF in three patients was probably induced by inappropriate pacing due to sensing failure.

CONCLUSIONS: Atrial overdrive pacing and bradycardia prevention pacing were not effective in the prevention of AF after CABG.

Key Words: arrhythmia, coronary artery bypass surgery, pacemaker, atrial fibrillation, overdrive pacing

*Corresponding author. Tel.: +358 17 173311. E-mail address: tapio.hakala{at}kuh.fi (T. Hakala).


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