Suppression of atrial fibrillation by multisite and septal pacing in a novel experimental model.

Abstract

OBJECTIVES:

To evaluate the preventive efficacy of multisite and septal atrial pacing in an experimental model.

METHODS:

Sterile right atrial pericarditis was induced in 12 foxhounds to provide an anatomical substrate for atrial fibrillation (AF). As a trigger mechanism, atrial extrasystoles were simulated by constant asynchronous pacing at a cycle length of 1000 ms from randomly selected right or left atrial electrodes, using a biatrial epicardial multielectrode with 128 bipoles. Additionally, a transvenous pacing lead was screwed into the interatrial septum. Four electrodes located in the high and low right (HRA/LRA) and left atrium (HLA/LLA) were selected for preventive multisite stimulation. Constant pacing at a cycle length 30 ms below sinus rate was applied from the following site(s): HRA, septal, HRA+LRA, HRA+LLA, HRA+LRA+LLA and HRA+LRA+HLA+LLA (order randomized). Number and duration of AF episodes were studied during 10 min intervals, separated by 5 min pauses, respectively. To validate the model, the protocol was repeated 10 min after i.v. bolus administration of D,L-sotalol (1 mg/kg body weight).

RESULTS:

The number of AF episodes decreased with increasing number of pacing sites, reaching statistical significance compared to HRA stimulation for quadruple-site and single-site septal pacing only (P<0.05). Single-site septal was as efficient as quadruple-site pacing in suppressing AF. The duration of AF episodes was not significantly affected by the pacing configuration. D,L-sotalol almost completely suppressed AF irrespective of the pacing configuration used.

CONCLUSIONS:

In this novel experimental model, quadruple-site and septal pacing effectively suppress paroxysmal AF.

• Authors: Ruediger Becker, Julia C Senges, Alexander Bauer, Kirsten D Schreiner, Frederik Voss, Wolfgang Kuebler, Wolfgang Schoels
• Journal: Cardiovascular research (Cardiovasc Res) Vol. 54 Issue 2 Pg. 476-81 (May 2002) ISSN: 0008-6363 [Print] England
• PMID: 12062353 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Adrenergic beta-Antagonists
• Sotalol

Topics

• Adrenergic beta-Antagonists (pharmacology)
• Analysis of Variance
• Animals
• Atrial Fibrillation (therapy)
• Cardiac Pacing, Artificial (methods)
• Dogs
• Heart Atria
• Heart Septum
• Models, Animal
• Pericarditis
• Sotalol (pharmacology)