Document Detail

Effective use of a novel rate-smoothing algorithm in atrial fibrillation by ventricular pacing.
MedLine Citation:
PMID:  9447324     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: It is still unknown whether a fast heart rate or an irregular ventricular response in atrial fibrillation causes tachycardiomyopathy. Reduction in the variability of RR intervals without an increase in heart rate might be an alternative treatment when antiarrhythmic drugs fail to control the irregularity accompanying atrial fibrillation. SUBJECTS AND METHODS: Eight patients underwent temporary right ventricular pacing, using a novel rate-smoothing algorithm prior to DC cardioversion or His bundle ablation. A rate-smoothing algorithm was utilized by right ventricular apical stimulation. Spontaneous and paced RR intervals during atrial fibrillation were quantified and processed for statistical analysis. RESULTS: The rate-smoothing algorithm resulted in a substantial reduction in the variance of the RR intervals (slow mode 73.1%, fast mode 40.0%) and RR range (slow mode 49.3%, fast mode 34.3%). In contrast to previous algorithms, the mean heart rate during pacing intervention in atrial fibrillation did not change significantly to the heart rate directly preceding the pacemaker intervention (+2%). CONCLUSIONS: This initial study of the novel rate-smoothing algorithm shows that pacing intervention is a relatively safe, rapid and reliable alternative therapy for controlling irregular ventricular rhythms due to atrial fibrillation. Incorporation of the algorithm in implantable pacemakers appears justified, but demands further prospective studies in patients to evaluate relief of symptoms and reduction of tachycardiomyopathy due to atrial fibrillation.
H J Duckers; N M van Hemel; J C Kelder; H Bakema; R Yee
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European heart journal     Volume:  18     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  1997 Dec 
Date Detail:
Created Date:  1998-03-18     Completed Date:  1998-03-18     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  1951-5     Citation Subset:  IM    
Department of Cardiology, St Antonius Hospital, Nieuwegein, The Netherlands.
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MeSH Terms
Atrial Fibrillation / therapy*
Cardiac Pacing, Artificial / methods*
Feasibility Studies
Middle Aged
Treatment Outcome
Comment In:
Eur Heart J. 1997 Dec;18(12):1849-50   [PMID:  9447309 ]

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