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Europace 2003 5(3):267-273; doi:10.1016/S1099-5129(03)00041-2
© 2003 by European Society of Cardiology
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Paroxysmal atrial fibrillation prevention by pacing in patients with pacemaker indication

I. F. Lozano1, A. Vincent2, J. Roda3, M. Méndez4, J. M. M. Ferrer5, F. Andrade6, J. J. Manzano7, R. Ceres8, J. Errejon8 and J. Toquero1

1Hospital Puerta de Hierro Madrid 28029, Spain; 2Vitatron Holland; 3Hospital General Universitario Valencia, Spain; 4Hospital Militar Gómez Ulla Madrid, Spain; 5Hospital Txagorritxu Vitoria, Spain; 6Hospital del Insalud Mérida, Spain; 7Hospital Dr Negrin, Las Palmas de Gran Canaria Spain; 8Hospital General de Albacete Albacete, Spain

AIMS: The prevent-atrial fibrillation (AF) registry analyses the clinical relevance and usefulness of the four preventive pacing algorithms, available in a family of cardiac stimulators, to prevent atrial fibrillation.

METHODS AND RESULTS: This study is a prospective, non-randomized, multicentre registry. Patients are eligible for the registry if they have sick sinus syndrome (SSS) with or without pre-existing atrial fibrillation. The preventive pacing algorithms were programmed for each patient on an individual basis using the diagnostic features of the devices. In the period from April 2000 to April 2001 a total of 68 patients (33 male, 35 female) has been included in the registry in 14 hospitals in Spain. Mean age was 72±12 years and the pacemaker indication was SSS in 15 patients (22%) and SSS with paroxysmal AF in 53 patients (78%). The median AF burden for the total group (n=32) was significantly reduced from 3.9 to 1.3% (67%, P=0.034, Wilcoxon signed rank test). The decrease in AF burden was accompanied by a non-significant decrease in the median number of episodes per day from 1.47 to 0.64 (a decrease of 56%). The average atrial pacing % was increased from 72 to 78%.

CONCLUSIONS: The prevent-AF registry demonstrated the usefulness of four preventive pacing algorithms in daily clinical practice. During the registry a significant reduction in AF burden and all other endpoints was observed. Dedicated diagnostics were key to adapting the optimal pacing therapy during follow-up.

Key Words: Atrial fibrillation, electrical stimulation, pacemaker, atrial fibrillation burden, sick sinus syndrome, pacing algorithms

Correspondence: Ignacio Fernández Lozano, Hospital Puerta de Hierro, C/Julio Palacios 20, 1° D, Madrid 28029, Spain. Tel.: +34-917337835; Fax: +34-913737091; E-mail: ifernandezl{at}sego.es


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A. R.J. Mitchell and N. Sulke
How do atrial pacing algorithms prevent atrial arrhythmias?
Europace, January 1, 2004; 6(4): 351 - 362.
[Abstract] [Full Text] [PDF]


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