Europace Advance Access originally published online on August 1, 2007
Europace 2007 9(9):805-811; doi:10.1093/europace/eum152
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PACING FOR ATRIAL FIBRILLATION
A novel method of multisite atrial pacing, incorporating Bachmann’s bundle area and coronary sinus ostium, for electrical atrial resynchronization in patients with recurrent atrial fibrillation
browska-Kugacka1
ski2
Zago
don3
1 Department of Cardiology and Electrotherapy, Medical University of Gdask, ul. D
binki 7, 80-211 Gdask, Poland;
2 Department of Cardiology, Medical University of Lublin, Lublin, Poland;
3 Department of Hygiene and Epidemiology, Medical University of Gdask, ul. Dbinki 7, 80-211 Gdask, Poland
Aims The aim of the study was to assess efficacy and safety of a novel method of multisite atrial pacing, incorporating Bachmann’s bundle (BB) and coronary sinus (CS) ostium pacing, which was implemented for the first time in atrial fibrillation (AF) patients with intra-atrial conduction delay.
Methods and results This follow-up study included 97 patients with drug refractory symptomatic AF, sinus node dysfunction, sinus P-wave 
120 ms, and normal atrioventricular conduction. Pacing efficacy was assessed on the basis of two main endpoints: successful rhythm control and the absence of documented or symptomatic AF. During the mean 2.3 ± 0.7 years of follow-up, the survival rate was 99%, pacing maintenance rate 97%, and the need for re-operation 5%. Rhythm control efficacy was 90%, and 14 patients had no evidence of recurrent AF. After implantation, the mean number of anti-arrhythmic drugs used (P < 0.0001), the need for cardioversion (P < 0.01), and the incidence (P < 0.0001) and duration (P < 0.001) of AF-related hospitalizations decreased. P-wave duration with multisite atrial pacing was shorter than during sinus rhythm, BB, and CS pacing (P < 0.0001).
Conclusion A novel method of multisite atrial pacing is safe, provides effective long-term rhythm control, and decreases the necessity for adjunctive therapies in patients with refractory AF and intra-atrial conduction delay.
Key Words: Atrial fibrillation, Atrial septum, Bachmann’s bundle, Coronary sinus, Pacing, Hybrid therapy
* Corresponding author. Tel: +48 58 349 39 10; fax: +48 58 349 39 20. E-mail address: elew{at}amg.gda.pl
Manuscript submitted 19 April 2007. Accepted after revision 4 July 2007.
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