© 2000 by European Society of Cardiology
ATRIAL ARRHYTHMIAS
New onset atrial flutter termination by overdrive transoesophageal pacing: effects of different protocols of stimulation
1Cardiology Department, Policlinico San Pietro Ponte San Pietro, Bergamo, Italy; 2University of Milan Italy
Abstract
AIM: We evaluated the effect of different stimulation protocols on atrial flutter interruption by transoesophageal pacing.
METHODS AND RESULTS: Eighty patients with new onset atrial flutter were randomized into four groups. Pacing was attempted under the following conditions: with short bursts (5 s), without treatment (group A) and after oral administration of propafenone 600 mg (group B); with prolonged bursts (30 s), without treatment (group C) and after oral administration of propafenone 600 mg (group D). Pacing interrupted atrial flutter in 20% of patients in A, 55% in B, 50% in C and 85% in D. The use of longer bursts gave better results both in patients without treatment (P< 0·05: C vs A) and in patients with propafenone (P< 0·05: D vs B). Comparing groups with the same stimulation protocol, we observed a better response in patients treated with propafenone (P< 0·05: B vs A and D vs C). In the groups without treatment the use of shorter bursts was associated with a lower induction of stable atrial fibrillation (three vs nine episodes), in the groups on propafenone no differences were observed (one vs one episode).
CONCLUSIONS: We conclude that the association of propafenone with long bursts gives the best result for interruption of new onset atrial flutter by transoesophageal pacing.
Key Words: Propafenone, atrial flutter, transoesophageal pacing
Correspondence: Flavio Doni, MD, Department of Cardiology and Coronary Unit, Policlinico San Pietro, Via Forlanini, 15, 24036 Ponte San Pietro, Bergamo, Italy.
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