BACKGROUND: Biphasic pacing is a novel mode of pacing that was suggested to increase cardiac conduction velocity as compared with cathodal monophasic pacing. We aimed to evaluate the safety and efficacy of rapid atrial pacing to convert atrial fibrillation (AF) to normal sinus rhythm. METHODS: Multiple biphasic (anodal/cathodal), reverse biphasic (cathodal/anodal), and monophasic (cathodal) atrial pacing therapies were performed among 12 patients undergoing left atrial catheter ablation for AF. The efficacy end point was successful conversion of AF to sinus rhythm, and safety end point no induction of ventricular arrhythmias. Patients were paced at three cycle lengths (100, 200, and 333 msec) for 60 seconds at three locations (right and left atrial appendages and coronary sinus). RESULTS: Among the 66 biphasic (anodal/cathodal) pacing procedures one procedure in a patient with chronic AF, which involved pacing at the left atrial appendage with a cycle length of 200 msec, led to conversion of AF to sinus rhythm. None of the 66 monophasic pacing procedures or the 66 reverse biphasic (cathodal/anodal) pacing procedures was associated with AF termination. None of the biphasic pacing procedures was associated with induction of ventricular arrhythmias. CONCLUSIONS: Rapid atrial pacing using a variety of waveforms at the cycle length and output used in the current study was found to be safe. There was a single success in converting a chronic AF to sinus rhythm.
BACKGROUND: Biphasic pacing is a novel mode of pacing that was suggested to increase cardiac conduction velocity as compared with cathodal monophasic pacing. We aimed to evaluate the safety and efficacy of rapid atrial pacing to convert atrial fibrillation (AF) to normal sinus rhythm. METHODS: Multiple biphasic (anodal/cathodal), reverse biphasic (cathodal/anodal), and monophasic (cathodal) atrial pacing therapies were performed among 12 patients undergoing left atrial catheter ablation for AF. The efficacy end point was successful conversion of AF to sinus rhythm, and safety end point no induction of ventricular arrhythmias. Patients were paced at three cycle lengths (100, 200, and 333 msec) for 60 seconds at three locations (right and left atrial appendages and coronary sinus). RESULTS: Among the 66 biphasic (anodal/cathodal) pacing procedures one procedure in a patient with chronic AF, which involved pacing at the left atrial appendage with a cycle length of 200 msec, led to conversion of AF to sinus rhythm. None of the 66 monophasic pacing procedures or the 66 reverse biphasic (cathodal/anodal) pacing procedures was associated with AF termination. None of the biphasic pacing procedures was associated with induction of ventricular arrhythmias. CONCLUSIONS: Rapid atrial pacing using a variety of waveforms at the cycle length and output used in the current study was found to be safe. There was a single success in converting a chronic AF to sinus rhythm.
Authors: W Paladino; M Bahu; B P Knight; R Weiss; J Sousa; A Zivin; R Goyal; E Daoud; K C Man; S A Strickberger; F Morady Journal: Am J Cardiol Date: 1997-07-15 Impact factor: 2.778
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Authors: Thomas H Everett; Joseph G Akar; Lai-Chow Kok; J Randall Moorman; David E Haines Journal: J Am Coll Cardiol Date: 2002-11-20 Impact factor: 24.094
Authors: Flavio H Fenton; Stefan Luther; Elizabeth M Cherry; Niels F Otani; Valentin Krinsky; Alain Pumir; Eberhard Bodenschatz; Robert F Gilmour Journal: Circulation Date: 2009-07-27 Impact factor: 29.690
Authors: Yeon Sik Choi; Hyoyoung Jeong; Rose T Yin; Raudel Avila; Anna Pfenniger; Jaeyoung Yoo; Jong Yoon Lee; Andreas Tzavelis; Young Joong Lee; Sheena W Chen; Helen S Knight; Seungyeob Kim; Hak-Young Ahn; Grace Wickerson; Abraham Vázquez-Guardado; Elizabeth Higbee-Dempsey; Bender A Russo; Michael A Napolitano; Timothy J Holleran; Leen Abdul Razzak; Alana N Miniovich; Geumbee Lee; Beth Geist; Brandon Kim; Shuling Han; Jaclyn A Brennan; Kedar Aras; Sung Soo Kwak; Joohee Kim; Emily Alexandria Waters; Xiangxing Yang; Amy Burrell; Keum San Chun; Claire Liu; Changsheng Wu; Alina Y Rwei; Alisha N Spann; Anthony Banks; David Johnson; Zheng Jenny Zhang; Chad R Haney; Sung Hun Jin; Alan Varteres Sahakian; Yonggang Huang; Gregory D Trachiotis; Bradley P Knight; Rishi K Arora; Igor R Efimov; John A Rogers Journal: Science Date: 2022-05-26 Impact factor: 63.714