[Incidence of atrial fibrillation in relation to atrial catheter site in two-chamber pacemakers].
BACKGROUND
This study evaluated the impact of the atrial lead implantation site on the subsequent development of atrial arrhythmias.


METHODS
Dual chamber pacemakers were implanted in 109 consecutive patients. The indication was AV-block in 51 patients, sick sinus syndrome in 58 patients. No patient had chronic atrial fibrillation, but 12 patients (11%) had paroxysmal atrial fibrillation before implantation. Patients were classified according to the atrial lead implantation site: right atrial appendage and right atrial free wall.


RESULTS
Preimplant episodes of atrial fibrillation were similar in patients with lead implantation at the free wall and with implantation in the right atrial appendix (13% vs 7.5%, P=0.53). During a mean follow-up of 24+/-13 months, new paroxysmal atrial fibrillation occurred in 5% after lead implantation in the appendix vs 28% of patients after implantation at the right atrial free wall (P = 0.004).


CONCLUSIONS
The development of atrial arrhythmias in dual chamber pacing is influenced by the implantation site of the atrial lead. The frequency of atrial arrhythmias during follow-up is higher after atrial lead implantation at the right lateral wall than in the appendix.
Herzzentrum Ludwigshafen.
K
K
Seidl
Drögemüller
B
B
Hauer
N
N
Schwick
R
R
Zahn
J
J
Senges
D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000209:etiology* / Q000503:physiopathology; D004562:Electrocardiography; D004567:Electrodes, Implanted; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria / Q000503:physiopathology; D006327:Heart Block / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D012307:Risk Factors; D012804:Sick Sinus Syndrome / Q000503:physiopathology / Q000628:therapy; D013614:Tachycardia, Paroxysmal / Q000209:etiology / Q000503:physiopathology