No evidence of automatic atrial overdrive pacing efficacy on reduction of paroxysmal atrial fibrillation

Voogt, W. de; Hemel, Norbert van; Vusser, Philip De; Mairesse, Georges H.; Mechelen, R. van; Koı̈stinen, Juhani; Bos, Arjan van den; Roose, I.; Voitk, Jüri; Yli‐Mäyry, Sinikka; Stockman, Dirk; Allaf, Dia El; Tse, Hung‐Fat; Lau, Chu‐Pak

doi:10.1093/europace/eum149

Cited by 28 publications

(20 citation statements)

References 29 publications

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“…In contrast, a recent study found no decrease by the AOP algorithm on AF burden, defined as the cumulative time spent in mode switch, in patients paced for standard indications and paroxysmal AF, whether from the right atrial appendage or from the low atrial septum. 15 As shown in our study, the correlation between the rate of detecting AHRE and the upper pacing rate is a key factor with respect to RNRVAS induced by AOP. Most previous studies did not provide enough detailed information regarding the detected RNRVAS.…”

Section: Prevention Of Af By the Aop Algorithmsupporting

confidence: 51%

Reliability and Characteristics of Atrial Tachyarrhythmias Detection in Dual Chamber Pacemakers

Kohno

Abe

Oginosawa

et al. 2011

Circ J

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Background: Although atrial high rate episodes (AHRE) have been commonly used to detect atrial tachyarrhythmias (AT/AF) in pacemaker patients, its reliability and characteristics are unclear. Methods and Results:39 patients with implanted dual chamber pacemakers (mean age 79.7±6.6 years), who had no history of AT/AF and were programmed in the setting of AHRE at >190 beats/min in DDD mode, were studied. An atrial overdrive pacing (AOP) algorithm was randomly programmed "ON" in 19 and "OFF" in 20 patients. AHRE were detected in 20 patients (51%), consisting of AT/AF in 15 and repetitive non-reentrant ventriculoatrial synchrony (RNRVAS) in 8 patients, all included in the AOP "ON" group. A total of 257 of 1,528 episodes of AHRE were available for analysis, including 181 and 76 episodes in the AOP "ON" and "OFF" groups, respectively. Among 181 episodes in the AOP "ON" group, 72 (40%) were RNRVAS, whereas all episodes in the AOP "OFF" group (100%) were AT/AF. Detection of RNRVAS was closely associated with a high cumulative % atrial pacing. The specificity of AT/AF detection by AHRE was 40% when the AOP algorithm was activated, vs. 100% when not in use.Conclusions: AT/AF was common in pacemaker patients without a history of AT/AF. The increase in cumulative % atrial pacing and the use of an AOP algorithm might be closely associated with RNRVAS, non-AT/AF, detected by AHRE. (Circ J 2011; 75: 1090 - 1097

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Section: Prevention Of Af By the Aop Algorithmsupporting

confidence: 51%

Reliability and Characteristics of Atrial Tachyarrhythmias Detection in Dual Chamber Pacemakers

Kohno

Abe

Oginosawa

et al. 2011

Circ J

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“…9,10 However larger trials were unable to confirm the initially positive results. 13,14 This difference can be explained by the 'mixed bag' of patients included in the larger trials who mostly had a short P-wave duration. Until now, atrial septum pacing could only be recommended in patients with a clearly prolonged P-wave duration (>120 msec), where shortening of the total atrial activation time is a clear component in the prevention of ATAs.…”

Section: Interruptive Pacing To Treat Atrial Fibrillationmentioning

confidence: 99%

Clinical application of pacemakers in atrial tachyarrhythmias

Voogt¹,

Hemel²

2008

NHJL

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“…[1][2][3][4][5][6] There is growing evidence to suggest that pacing at the atrial level in the region of Bachmann's bundle, the interatrial septum (IAS) or even multiple atrial sites may have advantages in patients with atrial fibrillation. [6][7][8][9][10] However, these specific site pacing techniques require extremely accurate lead positioning compared with those used for conventional bradycardia indications. 11 This may explain that adequate results have not yet been obtained with these new pacing approaches in a considerable number of patients.…”

Section: General Considerations: Specific Site Pacing Techniquesmentioning

confidence: 99%

Alternative pacing sites at the atrial level

Szili-Török¹,

Jordaens²,

Sutton³

2007

European Heart Journal Supplements

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Pacing the atria at alternative sites may have value in preventing atrial fibrillation but the available data so far fails to prove this point. This may be explained by inadequate lead positioning. Improvement in lead placement can now be achieved by use of advanced imaging techniques such as intracardiac echocardiography. Further studies are required in order to demonstrate the potential benefit that, for example, Bachmann's bundle stimulation should offer in atrial arrhythmia prevention.

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No evidence of automatic atrial overdrive pacing efficacy on reduction of paroxysmal atrial fibrillation

Abstract: We could not demonstrate a reduction of AF burden defined as cumulative time in AF by the AO algorithm, in patients who are paced for standard indications and PAF, neither from the RAA nor from the LAS.

Cited by 28 publications

References 29 publications

Reliability and Characteristics of Atrial Tachyarrhythmias Detection in Dual Chamber Pacemakers

Reliability and Characteristics of Atrial Tachyarrhythmias Detection in Dual Chamber Pacemakers

Clinical application of pacemakers in atrial tachyarrhythmias

Alternative pacing sites at the atrial level

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