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. 2013 Dec 31;6(4):856.
doi: 10.4022/jafib.856. eCollection 2013 Dec.

Role of Bi-Atrial Pacing In Slowing The Progression of Paroxysmal Atrial Fibrillation To Permanent Atrial Fibrillation

Raffaele Corbisiero  1 , Kathleen Zazzali  1 , David Muller  1
Affiliations

Role of Bi-Atrial Pacing In Slowing The Progression of Paroxysmal Atrial Fibrillation To Permanent Atrial Fibrillation

Raffaele Corbisiero et al. J Atr Fibrillation. .

Abstract

Introduction: Bi-atrial lead placement combined with atrial overdrive pacing has demonstrated a reduction in percent time mode switched and mode switches per day. This retrospective analysis compared long term outcomes of patients with right atrial overdrive pacing alone (DAO) to patients having atrial overdrive with bi-atrial leads (BIA) in slowing the progression of paroxysmal atrial fibrillation (PAF) to permanent continuous atrial fibrillation (CAF). Methods: Thirty-three patients age 76.6 (+/-1.96) from our prior investigation were selected. The DAO control group (N=16) had received a standard right atrial pacing lead. The BIA group (N=17) had pacing leads placed in the right atrium and coronary sinus. Patients were followed for a mean 1217 days (+/-838). Days of CAF was classified as the date of final mode switch until analysis. Results: A total of 40,171 follow-up days were evaluated. The mean follow-up for both cohorts was 1217 days (+/-838). The DAO group consisted of 15,318 days (mean 957 +/-761) and the BIA group 24,853 days (mean 1461 +/-854). A lower total number of days were spent in CAF in the BIA group versus the DAO group, 1380 vs 2197 respectively. Corrected for follow-up duration, 5.55% days in CAF was seen in the BIA group vs. 14.34% in the DAO group which did not reach statistical significance. Conclusions: Although BIA overdrive pacing initially demonstrated reduced time in mode switch compared to DAO alone, this analysis did not detect a reduction in progression to CAF. More subjects or a longer follow up would be needed.

Keywords: Atrial Fibrillation; Bi-Atrial pacing; Overdrive pacing.

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Figures

Figure 1
Figure 1. Chest radiographs showing biatrial pacemakers in situ. RA=Right Atrial; RV=Right Ventricle; CS-LA=Coronary Sinus lead pacing the Left Atrium
Figure 2
Figure 2. Follow up days vs. Days of Continuous Atrial Fibrillation. F/U=Follow up; CAF=Continuous atrial fibrillation
Figure 3
Figure 3. Atrial Fibrillation comparison between groups. d=Total Days; CAF=Continuous atrial fibrillation
See this image and copyright information in PMC

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