Pace‐Termination and Pacing for Prevention of Atrial Tachyarrhythmias: Results from a Multicenter Study with an Implantable Device for Atrial Therapy

Abstract

DDDRP pacing with a new system for AT therapy was safe and associated with successful pace-termination of AT in 53% of episodes. Preventive pacing and atrial ATP algorithms represent two new functions that can be implemented safely into pacemaker systems for nonpharmacologic treatment of ATs in patients requiring pacemaker therapy.

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

“…With deviceclassified efficacy criteria, approximately 30% to 60% of atrial tachyarrhythmias may be terminated with atrial ATP in patients who receive pacemakers for symptomatic bradycardia. [195][196][197] Although this has been associated with a reduction in atrial tachyarrhythmia burden over time in selected patients, 195,196 the success of this approach has not been duplicated reliably in randomized clinical trials. 197 Similar efficacy has been demonstrated in ICD patients 194,198,199 without compromising detection of VT, ventricular fibrillation (VF), or ventricular proarrhythmia.…”

New Insights Into the Initiation of Atrial Fibrillation

“…9 The short median duration of AF episodes of seconds or minutes in the majority of patients in the present study (72%) is comparable to the frequent detection of short AF episodes in other pacing trials. 5,10 This finding may explain the occurrence of asymptomatic AF episodes and may lead to an underestimation of the actual presence of AF; however, the clinical relevance of asymptomatic or short-lived AF and its influence on mortality and morbidity is as yet unknown.…”

2013 ESC Guidelines on Cardiac Pacing and Cardiac Resynchronization Therapy

“…Además, algunos dispositi- vos han incorporado algoritmos de estimulación cardiaca auricular antitaquicárdica (EAT) (gradiente de ritmo alto y estimulación cardiaca por descarga) para la terminación de la taquicardia auricular o el flutter auricular que podría degenerar en FA. Después del importante estudio multicéntrico de Israel et al 149 , se llevaron a cabo varios estudios aleatorizados que mostraron que los algoritmos preventivos tenían un beneficio incremental mínimo o nulo en la prevención de FA (tabla 20) [150][151][152][153][154][155][156][157][158][159] . En el más amplio de estos estudios 153,154 , se aleatorizó a 2.343 pacientes con hipertensión y sin antecedentes de FA a los que se implantó marcapasos o desfibrilador a recibir o no sobrestimulación auricular continua, lo que no evitó la FA o el resultado clínico de accidente cerebrovascular, embolia sisté-mica, infarto de miocardio, muerte por causas vasculares u hospitalización por IC.…”