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Europace 2008 10(1):28-34; doi:10.1093/europace/eum268
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org
The online version of this article has been published under an open access model. Users are entitled to use, reproduce, disseminate, or display the open access version of this article for non-commercial purposes provided that the original authorship is properly and fully attributed; the Journal, Learned Society and Oxford University Press are attributed as the original place of publication with correct citation details given; if an article is subsequently reproduced or disseminated not in its entirety but only in part or as a derivative work this must be clearly indicated. For commercial re-use, please contact journals.permissions©oxfordjournals.org.

ATRIAL FIBRILLATION

Impact of anti-tachycardia pacing on atrial fibrillation burden when added on top of preventive pacing algorithms: results of the prevention or termination (POT) trial

Lluís Mont1,*, Ricardo Ruiz-Granell2, Juan Gabriel Martínez3, José Ramon Carmona4, Marisa Fidalgo5, Erik Cobo6, Mireia Riera7, Xavier Navarro on behalf of the Prevention or Termination (POT) Study investigators7

1 Thorax Institute, Hospital Clinic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Villarroel 170, Barcelona 08036, Catalonia, Spain; 2 Arrhythmia Unit, Cardiology Department, Hospital Clinico Universitario, Valencia, Spain; 3 Arrhythmia Unit, Cardiology Department, Hospital General Alicante, Alicante, Spain; 4 Arrhythmia Unit, Cardiology Department, Hospital de Navarra, Pamplona, Spain; 5 Arrhythmia Unit, Cardiology Department, Hospital de León, Spain; 6 Universitat Politècnica de Catalunya, Barcelona, Spain; 7 Scientific and Clinical Department, Medtronic Ibérica, Barcelona, Spain

Aims: The efficacy of preventive pacing algorithms (PPA) and anti-tachycardia pacing (ATP) in reducing atrial fibrillation (AF) burden remains controversial. The aim of this study was to assess whether ATP on top of PPA decreases AF burden.

Methods and results: A series of 199 consecutive patients, with conventional indications for pacing, and documented AF, received a DDDR (rate adaptive dual chamber pacemaker) pacemaker with ATP capabilities (AT 500 Medtronic). After 3 months of conventional DDDR pacing at 70 b.p.m., AF burden was analysed. If patients had >30 min/week of AF, they were randomized to PPA or to PPA+ATP for 3 months (period 1). They were then crossed to the alternative therapy (period 2) and followed three additional months with a 1-month wash out period in-between. A group of 85 patients were randomized. Mean age 68 ± 8 years, 61% men. Both groups showed a significant decrease in AF burden at the end of period 1 (64 and 81%, respectively).

Conclusions: Atrial pacing with PPA decreases AF burden in patients with pacing indication. We did not observe a further decrease in AF burden or in the number of episodes when adding ATP on top of PPA.

Key Words: Anti-tachycardia pacing, ATP, Preventive pacing algorithms, Atrial fibrillation burden, POT trial, AT500

* Corresponding author. Tel: +34 93 2275551; fax: +34 93 4513045.E-mail address: lmont{at}clinic.ub.es


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