Atrial septal pacing: a new approach to prevent atrial fibrillation.

Abstract

Atrial pacing may prevent the onset of atrial fibrillation (AF) because of: (1) prevention of the relative bradycardia that triggers paroxysmal AF; (2) prevention of the bradycardia induced dispersion of refractoriness; (3)suppression or reduction of premature atrial contractions that initiate reentry and predispose to AF; (4) preservation of AV synchrony, which might prevent switch induced changes in atrial repolarization predisposing to AF. Atrial pacing locations that decrease atrial activation and dispersion of refractoriness may be preferable in patients with a history of AF. Two different interatrial septum sites have been proposed: the Bachmann's bundle and the coronary sinus ostium. The results of two prospective randomized studies indicate that septal pacing, when compared to the traditional right atrial appendage pacing, significantly reduces : (1) paroxysmal AF recurrences and burden; and (2) progression to chronic AF.

• Authors: Luigi Padeletti, Antonio Michelucci, Paolo Pieragnoli, Andrea Colella, Nicola Musilli
• Journal: Pacing and clinical electrophysiology : PACE (Pacing Clin Electrophysiol) Vol. 27 Issue 6 Pt 2 Pg. 850-4 (Jun 2004) ISSN: 0147-8389 [Print] United States
• PMID: 15189515 (Publication Type: Journal Article, Review)

Topics

• Animals
• Atrial Fibrillation (physiopathology, prevention & control)
• Bradycardia (prevention & control)
• Cardiac Pacing, Artificial (methods)
• Electrophysiologic Techniques, Cardiac
• Heart Atria
• Heart Septum
• Humans
• Pacemaker, Artificial