[Atrial pacing for prevention of atrial fibrillation. Influence of septal atrial pacing, atrial overdrive and AV-delay-optimization on atrial fibrillation burden].

BACKGROUND: Atrial overdrive and optimized interatrial conduction time can reduce atrial fibrillation (AF). Increased ventricular stimulation results in a higher incidence of atrial fibrillation. PATIENTS AND METHODS: In 25 patients with paroxysmal AF, a dual-chamber pacemaker (Identity DR 5370, St. Jude Medical) was implanted. Atrial leads were placed randomly either septal (n=12) or conventional (n=13). Dynamic atrial overdrive (DAO) was activated and the AV delay was optimized according to Koglek's method. After 3, 6, 9, and 12 months automatic mode switch (AF burden) was analysed.
RESULTS: No difference in implantation parameters were observed between groups. Technical implantation parameters were in the normal range for both groups. After 12 months patients in the septal group had less AF burden (1% vs. 7%, p=0.06), and the total number of AF episodes was reduced.
CONCLUSION: Septal pacing is safe. In combination with DAO and AV delay optimization it may reduce the AF burden, which can be observed after 12 months.

RCT Entities:   Population Interventions Outcomes