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Europace Advance Access published online on March 29, 2007
Europace, doi:10.1093/europace/eum006
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© The European Society of Cardiology 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

On the role of ventricular conduction time in rate stabilization for atrial fibrillation

Jie Lian*, Dirk Müssig and Volker Lang

Micro Systems Engineering, Inc., 6024 SW Jean Road, Lake Oswego, OR 97035, USA

Aims Ventricular pacing (VP) could stabilize the ventricular rhythm in atrial fibrillation (AF). This study investigates the role of ventricular conduction time (VCT) in rate stabilization for AF.

Methods and results A novel computer model was used to generate various patterns of RR intervals in AF. For each model configuration, the rate stabilization effect of VP was compared with respect to different VCTs. In all tested cases, the ventricular rate in AF could be stabilized at pacing intervals longer than the shortest spontaneous RR intervals. For each model configuration, slightly longer pacing interval (difference <100 ms) was needed to achieve 95% VP when the antegrade/retrograde VCT was increased from 10/10 to 110/110 ms, whereas the VCT had less effect at lower pacing rate. Although longer VCT was associated with increased percentage of ventricular fusion, its role was diminished at higher pacing rate when more retrograde waves could conduct to the atrium.

Conclusion Ventricular conduction time has limited effects on rate stabilization, which could be explained by multi-level interactions between antegrade waves induced by AF and retrograde waves induced by VP.

Key Words: Rate stabilization, Atrial fibrillation, Ventricular pacing, Ventricular conduction time

* Corresponding author. Tel: +503 635 4016; fax: +503 635 9610. E-mail address: jie.lian{at}biotronik.com

Manuscript submitted 12 September 2006. Accepted after revision 17 December 2006.


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J. Lian, D. Mussig, and V. Lang
Ventricular rate smoothing for atrial fibrillation: a quantitative comparison study
Europace, July 1, 2007; 9(7): 506 - 513.
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