Document Detail


Atrial pacing periablation for prevention of paroxysmal atrial fibrillation.
MedLine Citation:
PMID:  10330387     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: This study tested the hypothesis that rate-adaptive atrial pacing would prevent paroxysmal atrial fibrillation (PAF) in patients with frequent PAF in the absence of symptomatic bradycardia. METHODS AND RESULTS: Patients (n=97) with antiarrhythmic drug-refractory PAF received a Medtronic Thera DR pacemaker 3 months before planned AV node ablation. Patients were randomized to no pacing (n=48) or to atrial rate-adaptive pacing (n=49). After a 2-week stabilization period, patients were followed up for an additional 10 weeks. The time to first recurrence of sustained PAF, the interval between successive episodes of PAF, and the frequency of PAF were compared between the 2 groups in intention-to-treat analysis. Time to first episode of sustained PAF was similar in the no-pacing (4.2 days; 95% CI, 1.8 to 9.5) and the atrial-pacing (1.9 days; 95% CI, 0.8 to 4.6; P=NS) groups. PAF burden was lower in the no-pacing (0.24 h/d; 95% CI, 0.10 to 0.56) than in the atrial-pacing (0.67 h/d; 95% CI, 0.30 to 1.52; P=0.08) group. Paired crossover analysis in 11 patients revealed that time to first PAF was shorter during atrial pacing (1.6 days; 95% CI, 0.6 to 4.9) than with no pacing (6.0 days; 95% CI, 2.4 to 15.0; P=0.13), and PAF burden was greater during atrial pacing (1.00 h/d; 95% CI, 0.35 to 2.91) than with no pacing (0.32 h/d; 95% CI, 0.09 to 1.13; P<0.016). CONCLUSIONS: Atrial rate-adaptive pacing does not prevent PAF over the short term in patients with antiarrhythmic drug-resistant PAF without symptomatic bradycardia.
Authors:
A M Gillis; D G Wyse; S J Connolly; M Dubuc; F Philippon; R Yee; P Lacombe; M S Rose; C D Kerr
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Circulation     Volume:  99     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1999 May 
Date Detail:
Created Date:  1999-06-08     Completed Date:  1999-06-08     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  2553-8     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiology, The University of Calgary, Calgary, Alberta, Canada. amgillis@ucalgary.ca
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Atrial Fibrillation / mortality,  prevention & control*
Cardiac Pacing, Artificial*
Electrocardiography
Female
Humans
Male
Survival Analysis

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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