Abstract | OBJECTIVE: Evaluate the effects of optimized atrial stimulation--OAS (dual-site atrial pacing, heart rate above the intrinsic rate, and specific functional algorithm), and the use of atenolol in preventing recurrent atrial fibrillation (AF). Primary endpoint: to quantify the rate of AF episodes. Secondary endpoints: assessment of quality of life, specific cardiovascular symptoms, rate of hospital admissions, rate of electrical and pharmacological cardioversions, and adverse cardiac events. METHODS: Twenty-five patients with recurrent episodes of paroxysmal AF and sinus node disease had dual-site atrial and ventricular pacemakers implanted, and were started on atenolol, 100 mg/day. Next, they were randomized to two groups: GROUP I: first three months with OAS and the specific pacing algorithm (DAO) turned on, and three more months with the algorithm off. GROUP II: the inverse sequence to GROUP I. The pacing mode chosen was DDDR, and after three months patients underwent clinical and electronic evaluations of the stimulation system by: automatic mode switch (AMS), 24-hour Holter monitoring, Doppler echocardiogram, and SF-36 questionnaire. Following, a crossover comparison took place, and a new assessment was performed six months later. RESULTS: When compared to the group with the algorithm turned off, OAS patients had lower rates of: AF/week (p < 0.001); AMS activations (p < 0.01); hospitalizations (p < 0.001); cardioversions (p < 0.001), and higher scores on the physical and mental components of quality of life. CONCLUSION: The hybrid therapy adopted, OAS associated with the use of atenolol, reduced the rate of recurrent AF and improved the clinical-functional status of patients with symptomatic bradyarrhythmias.
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Authors | Antonio da Silva Menezes Jr, Martino Martinelli Filho, Carlos Cléber dos Santos Menezes, Roberto Costa, José Antônio Franchini Ramires |
Journal | Arquivos brasileiros de cardiologia
(Arq Bras Cardiol)
Vol. 88
Issue 1
Pg. 1-7
(Jan 2007)
ISSN: 1678-4170 [Electronic] Brazil |
PMID | 17364111
(Publication Type: Journal Article, Randomized Controlled Trial)
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Chemical References |
- Anti-Arrhythmia Agents
- Atenolol
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Algorithms
- Anti-Arrhythmia Agents
(therapeutic use)
- Atenolol
(therapeutic use)
- Atrial Fibrillation
(prevention & control)
- Cardiac Pacing, Artificial
- Combined Modality Therapy
- Cross-Over Studies
- Electric Countershock
- Female
- Follow-Up Studies
- Humans
- Male
- Middle Aged
- Prospective Studies
- Quality of Life
- Secondary Prevention
- Sick Sinus Syndrome
(therapy)
- Single-Blind Method
- Time Factors
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