Document Detail

Mechanisms of pacing interventions in atrial fibrillation.
MedLine Citation:
PMID:  9727670     Owner:  NLM     Status:  MEDLINE    
Atrial flutter is due to large single reentrant loops, typically oriented around the caval veins and a line of functional conduction block in between. These reentrant circuits can easily be terminated by properly timed extra beats colliding in the antidromic direction with the reentrant orthodromic wavefront and being blocked in the orthodromic direction within the area of slow conduction. Due to the complex situation in atrial fibrillation with multiple, ever-changing wavelets and a marked functional inhomogeneity of the atrial tissue, these simple concepts do not apply. However, regional control of atrial tissue by rapid pacing is feasible during atrial fibrillation, and through a multisite approach, this pacing modality might lead to a situation where the remaining nonentrained atrial tissue is just no longer reaching the critical mass. Single-site, dual-site, and biatrial pacing seems to reduce the incidence of atrial fibrillation recurrences. Specific advantages and disadvantages of each approach still need to be elucidated. Apart from preventing bradycardia, preventive pacing modes reduce intra-atrial conduction times and might reduce intra-atrial dispersion of refractoriness. Still, the specific mechanisms relevant for their effectiveness need further clarification.
W Schoels; R Becker
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  9     ISSN:  1045-3873     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  1998 Aug 
Date Detail:
Created Date:  1998-11-30     Completed Date:  1998-11-30     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  S13-7     Citation Subset:  IM    
Department of Cardiology, University of Heidelberg, Germany.
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MeSH Terms
Atrial Fibrillation / physiopathology,  therapy*
Cardiac Pacing, Artificial*

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