Atrial lead placement at the lower atrial septum: a potential strategy to reduce unnecessary right ventricular pacing

Abstract

When compared with RAA pacing, LAS pacing was associated with a shorter P wave duration, PR interval, As-Vs, and Ap-Vs intervals. The potential long-term impact of the strategy of pacing from LAS in reducing unnecessary RV pacing needs to be explored in future studies.

Atrial Pacing Site and Atrioventricular Conduction in Patients Paced for Sinus Node Disease

“…The advantage of LRAS, compared with RAA pacing, is its closer anatomical location to the AV node. This, compared with RAA pacing, may decrease the rate of unnecessary ventricular pacing . The EPASS study showed that LRAS is more effective that RAA pacing in the prevention of persistent AF in patients with SND and intraatrial conduction delays .…”

“…This, compared with RAA pacing, may decrease the rate of unnecessary ventricular pacing. 14,15 The EPASS study showed that LRAS is more effective that RAA pacing in the prevention of persistent AF in patients with SND and intraatrial conduction delays. 3 Wang et al investigated and compared hemodynamic effects between LRAS and RAA pacing in SND patients with paroxysmal AF.…”

Prospective Randomized Study to Assess the Efficacy of Site and Rate of Atrial Pacing on Long-Term Progression of Atrial Fibrillation in Sick Sinus Syndrome

“…Moreover, because of the proximity to the atrioventricular node, intrinsic conduction was promoted, over and above the automatic intrinsic search algorithm in this device. 26 A recent study on progressive atrial electrophysiological property changes in device patients without a history of AF has also identified P-wave duration as a marker of future AF development, 27 rather than a change in the atrial effective refractory period. This underlies the importance of atrial conduction as an electrophysiological mechanism of AF development.…”

Pacing and Defibrillators in Complex Congenital Heart Disease

“…In general, atrial lead placement is less critical, but atrial septal pacing may reduce unnecessary ventricular pacing when compared with appendage pacing. 30 Ventricular lead placement is highly dependent upon the cardiac anatomy and whether an endocardial or epicardial approach has been adopted. For endocardial pacing in the AV Post-Senning 22-35 % [7][8][9] All atrial switch 4 % 10 29 and this finding is replicated on systematic review.…”