Document Detail

Atrial Pacing Site and Atrioventricular Conduction in Patients Paced for Sinus Node Disease.
MedLine Citation:
PMID:  24946835     Owner:  NLM     Status:  Publisher    
BACKGROUND: Unnecessary ventricular pacing in sinus node disease (SND) must be avoided. To test the hypothesis that in SND, with or without 1(st) degree atrioventricular (AV) block, cumulative percent ventricular pacing (cum%VP) can be limited by low right atrial septal (LRAS) instead of right atrial appendage (RAA) pacing.
METHODS: We studied 102 dual-chamber pacemaker recipients with SND. The PQ interval on 12-lead electrocardiogram and the atrial paced to ventricular sensed interval (Ap-Vs) during LRAS and RAA pacing were measured and compared at implantation, 3 months and 1 year of follow-up. Group 1 included 62 patients with baseline PQ interval <200 ms during LRAS (n = 28) versus RAA (n = 34) pacing. Group 2 included 40 patients with baseline PQ ≥200 ms during LRAS (n = 20) versus RAA (n = 20) pacing. Cum%VP were measured at 3 months and 1 year.
RESULTS: The characteristics and AV conduction properties were similar and the Ap-Vs interval was significantly shorter in the LRAS than in the RAA pacing group up to 1 year (193±32ms vs. 220±27ms in Group 1; P = 0.003, 222±41ms vs. 281±30ms in Group 2; P<0.001). While cum%AP was consistently similar, cum%VP was significantly smaller during LRAS than RAA pacing (1±1% vs. 8±18% in Group 1; P = 0.03, 7±10% vs. 48±38% in Group 2; P<0.001). Similar observations were made with or without left atrial enlargement.
CONCLUSION: Compared with RAA, LRAS pacing showed shorter AV interval in SND patients with or without 1(st) degree AV block and left atrial enlargement. This beneficial effect persisted through 1-year follow-up, and decreased cum%VP significantly. This article is protected by copyright. All rights reserved.
Taichi Watabe; Haruhiko Abe; Ritsuko Kohno; Yasushi Oginosawa; Katsuhide Hayashi; Hisaharu Ohe; Masahito Tamura; Masaaki Takeuchi; Yutaka Otsuji
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-6-20
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  -     ISSN:  1540-8167     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  2014 Jun 
Date Detail:
Created Date:  2014-6-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
This article is protected by copyright. All rights reserved.
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