Prevention of atrial fibrillation by inter-atrial septum pacing guided by electrophysiological testing, in patients with delayed interatrial conduction

Manolis, Athanasios G.; Katsivas, Apostolos; Vassilopoulos, Charis; Koutsogeorgis, Dimitris; Louvros, Nikolaos

doi:10.1053/eupc.2002.0232

Cited by 22 publications

(23 citation statements)

References 28 publications

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“…The stimulation of the interatrial septum is deemed by many research ers to be the best pacing placement with regards to the activation time of both atria, which seems to be in line with the theoretical model [16,17]. In some studies this kind of atrial pacing was also combined with paroxysmal atrial fibrillation pre vention [18,19]. The most important factor influ encing the study results and the clinical effect in a particular population was the interatrial conduc tion disorder leading to the electrical and/or he modynamic deterioration and subsequent atri al fibrillation.…”

Section: Discussionmentioning

confidence: 69%

Bachmann’s Bundle Pacing not Only Improves Interatrial Conduction but Also Reduces the Need for Ventricular Pacing

Sławuta

Kliś²,

Skoczyński

et al. 2016

Adv Clin Exp Med

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in a surface electrocardiogram. A slower inter atrial conduction takes place in the coronary si nus. The physiological left atrial contraction de lay amounts to 22 ± 11 ms in relation to the right atrium [1][2][3].The interatrial conduction disorders are rela tively common in sick sinus syndrome patients, which contribute to atrial arrhythmias, in par The implantation of a permanent pacemaker alters the electrophysiological and hemodynam ic relations in a heart. The electrical physiologi cal activation of the atria comes from the sino atrial node. The left atrium activation is achieved throughout the conductive tissue layer called the Objectives. This study was aimed to assess the influence of the atrial pacing site on interatrial and atrioventricular conduction as well as the percentage of ventricular pacing in patients with sick sinus syndrome implanted with atrioventricular pacemaker. Material and Methods. The study population: 96 patients (58 females, 38 males) aged 74.1 ± 11.8 years were divided in two groups: Group 1 (n = 44) with right atrial appendage pacing and group 2 (n = 52) with Bachmann's area pacing. We assessed the differences in atrioventricular conduction in sinus rhythm and atrial 60 and 90 bpm pacing, Pwave duration and percentage of ventricular pacing. Results. No differences in baseline Pwave duration in sinus rhythm between the groups (102.4 ± 17 ms vs. 104.1 ± 26 ms, p = ns.) were noted. Atrial pacing 60 bpm resulted in longer Pwave in group 1 vs. group 2 (138.3 ± 21 vs. 106.1 ± 15 ms, p < 0.01). The differences between atrioventricular conduction time during sinus rhythm and atrial pacing at 60 and 90 bpm were significantly longer in patients with right atrial appendage vs. Bachmann's pacing (44.1 ± 17 vs. 9.2 ± 7 ms p < 0.01 and 69.2 ± 31 vs. 21.4 ± 12 ms p < 0.05, respectively). The percentage of ventricular pacing was higher in group 1 (21 vs. 4%, p < 0.01). Conclusions. Bachmann's bundle pacing decreases interatrial and atrioventricular conduction delay. Moreover, the frequencydependent atrioventricular conduction lengthening is much less pronounced during Bachmann's bundle pacing. Right atrial appendage pacing in sick sinus syndrome patients promotes a higher percentage of ventricular pacing (Adv Clin Exp Med 2016, 25, 5, 845-850).

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Section: Discussionmentioning

confidence: 69%

Bachmann’s Bundle Pacing not Only Improves Interatrial Conduction but Also Reduces the Need for Ventricular Pacing

Sławuta

Kliś²,

Skoczyński

et al. 2016

Adv Clin Exp Med

View full text Add to dashboard Cite

show abstract

“…The stimulation of septum is considered in many papers to be the best pacing place with regard to the both atria activation time (17)(18)(19), which seems to be concordant with a theoretical model. In some p a p e r s t h i s k i n d o f a t r i a l stimulation site was also combined with the prevention of paroxysmal atrial fibrillation (20,21). On the other hand the right atrium appendage pacing provides a better hemodynamic response -better left ventricle filling and a higher cardiac output in comparison to the right atrium free wall stimulation.…”

Section: Wwwintechopencommentioning

confidence: 99%

The Alternative Atrial Pacing Sites

Gajek¹,

Skoczyński²,

Sławuta³

2011

Modern Pacemakers - Present and Future

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“…Pacing at BB or the CSo did not lead to significantly shorter PWDs compared with SR, which contrasts our findings and those of Manolis. 39 However, the combination of BB and…”

Section: The Variable Effects Of Septal Pacing On P-wave Duration In mentioning

confidence: 99%

“…The first explanation is related to clinical characteristics of study subjects, such as history of AF, burden or type of AF, size of atria, etc. 34,39 For example, Lewicka-Nowak et al 40 reported a specific group of patients with extremely prolonged P waves (145 + 17 ms), symptomatic of documented recurrent AF. Pacing at BB or the CSo did not lead to significantly shorter PWDs compared with SR, which contrasts our findings and those of Manolis.…”

Section: The Variable Effects Of Septal Pacing On P-wave Duration In mentioning

confidence: 99%

Effects of baseline P-wave duration and choice of atrial septal pacing site on shortening atrial activation time during pacing

et al. 2012

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BackgroundAtrial septal pacing (ASP) has been shown to shorten P-wave duration (PWD) and reduce recurrence of atrial fibrillation (AF) in patients with bradyarrhythmias. However, variability of interatrial connections and atrial conduction properties may explain ASP's modest clinical benefit. The aim of this study was to assess the effect of ASP site on the duration of the paced P wave. Methods and resultsAtrial septal pacing at high atrial septum (HAS), posterior septum behind the fossa ovalis (PSFO), and coronary sinus ostium (CSo) was performed in 69 patients admitted for electrophysiological study (52 + 16 years, 41 men). Twelvelead electrocardiogram was recorded at baseline and during pacing, signal-averaged for analysis of PWD and P-wave shortening achieved by ASP (DPWD ¼ paced PWD-baseline PWD). Baseline PWD was 128 + 15 ms. The shortest PWD during pacing was achieved at CSo (112 + 15 ms) followed by HAS (122 + 14 ms, P , 0.001 vs. CSo) and PSFO (124 + 21 ms, P , 0.001 vs. CSo). P wave was shortened during pacing in patients with baseline PWD of . 120 ms (n ¼ 50), whereas those with PWD of ≤ 120 ms showed PWD lengthening (n ¼ 19) when paced at HAS (8 + 17 vs. 212 + 15 ms, P , 0.001), PSFO (15 + 17 vs. 212 + 26 ms, P , 0.001) and CSo (6 + 16 vs. 225 + 18 ms, P , 0.001). ConclusionPacing at CSo is associated with the shortest PWD. P-wave shortening is greatest in patients with baseline PWD of . 120 ms regardless of the pacing site. The results may have implications on the selection of candidates for ASP and the placement of the atrial septal lead, and warrant further evaluation in cases of permanent pacing in patients with paroxysmal AF.--

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Prevention of atrial fibrillation by inter-atrial septum pacing guided by electrophysiological testing, in patients with delayed interatrial conduction

Cited by 22 publications

References 28 publications

Bachmann’s Bundle Pacing not Only Improves Interatrial Conduction but Also Reduces the Need for Ventricular Pacing

Bachmann’s Bundle Pacing not Only Improves Interatrial Conduction but Also Reduces the Need for Ventricular Pacing

The Alternative Atrial Pacing Sites

Effects of baseline P-wave duration and choice of atrial septal pacing site on shortening atrial activation time during pacing

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