Atrial septal pacing to prevent atrial fibrillation in patients with sinus node dysfunction: Results of a randomized controlled study

ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities

“…197,210 Dual-site right atrial pacing or alternate single-site atrial pacing from unconventional sites (e.g., atrial septum or Bachmann's bundle) may offer additional benefits to single-site right atrial pacing from the appendage in patients with symptomatic drugrefractory AF and concomitant bradyarrhythmias; however, results from these studies are also contradictory and inconclusive. 211,212 Additionally, analysis of the efficacy of pacing prevention algorithms and alternative pacing sites is limited by short-term follow-up. 213 In patients with sick sinus syndrome and intra-atrial block (P wave more than 180 milliseconds), biatrial pacing may lower recurrence rates of AF.…”

Efficacy of Low Interatrial Septum and Right Atrial Appendage Pacing for Prevention of Permanent Atrial Fibrillation in Patients With Sinus Node Disease

“…Padeletti et al 5 showed that rate-adaptive pacing at the triangle of Koch is more effective than RAA pacing in preventing symptomatic recurrences of paroxysmal AF in patients with sinus bradycardia and a history of AF. However, 2 subsequent prospective, randomized studies 7,8 in similar patient populations failed to demonstrate this superiority of IAS to conventional appendage pacing. A major difference between all these previous studies and the present one is that we used persistent or permanent AF as the primary end point.…”

“…However, this preventive effect of IAS pacing on AF has not been observed in other prospective, randomized, controlled clinical studies. 7,8 The presence of shortened atrial refractoriness, atrial refractoriness dispersion and intra-atrial conduction delay have been identified as predictors of postpacing AF occurrence in patients with sinus node dysfunction (SND) receiving conventional RAA pacing. 9,10 The potential relationship between individual atrial electrophysiological properties and AF development during chronic atrial pacing at different atrial sites has not yet been investigated.…”

2012 ACCF/AHA/HRS Focused Update Incorporated Into the ACCF/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities

“…197,210 Dual-site right atrial pacing or alternate single-site atrial pacing from unconventional sites (eg, atrial septum or Bachmann's bundle) may offer additional benefits to single-site right atrial pacing from the appendage in patients with symptomatic drug-refractory AF and concomitant bradyarrhythmias; however, results from these studies are also contradictory and inconclusive. 211,212 Additionally, analysis of the efficacy of pacing prevention algorithms and alternative pacing sites is limited by short-term follow-up. 213 In patients with sick sinus syndrome and intra-atrial block (P wave more than 180 milliseconds), biatrial pacing may lower recurrence rates of AF.…”