Pacing therapy for atrial tachyarrhythmias

Abstract

Summary:The use of pacing techniques for the treatment of atrial tachyarrhythmias has been advocated for more than 30 years. Although it has played a beneficial role in the management of paroxysmal supraventricular tachycardia (PSVT) in drug-refractory patients, tachycardia acceleration and development of atrial fibrillation has been the major drawback. With the availability of radiofrequency catheter ablation therapy, the use of implantable antitachycardia devices for PSVT is currently negligible. From retrospective and small control studies it has been shown that atrial or dual-chamber pacing in patients with sick sinus syndrome has been associated with a lower incidence of paroxysmal atrial flutter or fibrillation than in those who received a ventricular pacemaker. Furthermore, recent studies have reported the potential benefit of reducing frequency of paroxysmal atrial flutter and fibrillation with multisite atrial pacing. As a result, there is a resurgence of research interest in antitachycardia pacing for prevention of atrial tachyarrhythmias. This paper briefly describes the basic aspects of antitachycardia pacing, reviews the data on the use of implantable antitachycardia devices for PSVT and the selection of patients, and assesses the current status of research on atrial pacing for prevention of paroxysmal atrial flutter and fibrillation.

Maternal focal atrial tachycardia during pregnancy: A systematic review

“…Atrial overdrive pacing is unlikely to be successful in pregnant patients with focal AT and it is not recommended in the SVT guideline 6 . This therapy has been studied in patients with implanted permanent pacemakers and success rates are low for focal AT arising from triggered or automatic mechanisms 54 . Women in the child‐bearing ages are unlikely to have permanent pacemakers.…”