title: Advanced pacemaker diagnostic features in the characterization of atrial fibrillation: impact on preventive pacing algorithms.
abstract: Pacing algorithms to prevent PAF are mainly based on the suppression of premature atrial complexes (PACs), which play an important role in its initiation. In contrast to 24-hour ambulatory electrocardiograms, advanced pacemaker (PM) diagnostic features are capable of recording AF episodes during long follow-up periods and of characterizing AF in a detailed fashion. For the specific use of these algorithms, a detailed characterization of AF was performed in 91 dual chamber PM recipients with histories of AF. Fifteen patients with episodes of oversensing due to far-field signals or frequent episodes of "2:1-undersensing" of atrial flutter were excluded. The remaining 76 patients had high recurrence rates of AF (median 0.8 episodes/day), however, the majority of episodes lasted < 7 minutes. Despite frequent PACs (median 10.8/hour) during sinus rhythm, a median of 66.4% of the AF episodes were preceded by < 2 PACs/min before onset. In conclusion, frequent, short-lived AF episodes seem best suited for AF preventive pacing therapies. However, the small number of PACs preceding many AF episodes may limit the efficacy of PAC suppressing algorithms.
authors.affiliation: Dept. of Cardiology, University of Bonn, Sigmund-Freud-Str. 25, D-53105 Bonn, Germany. ji_hoon_yang@yahoo.de
authors.forename: Alexander
authors.initials: A
authors.lastname: Yang
authors.forename: Marc
authors.initials: M
authors.lastname: Hochhäusler
authors.forename: Jan
authors.initials: J
authors.lastname: Schrickel
authors.forename: Helga
authors.initials: H
authors.lastname: Bielik
authors.forename: Nikolay
authors.initials: N
authors.lastname: Shlevkov
authors.forename: Rainer
authors.initials: R
authors.lastname: Schimpf
authors.forename: Jörg Otto
authors.initials: JO
authors.lastname: Schwab
authors.forename: Bahman
authors.initials: B
authors.lastname: Esmailzadeh
authors.forename: Christian
authors.initials: C
authors.lastname: Schneider
authors.forename: Fritz
authors.initials: F
authors.lastname: Mellert
authors.forename: Armin
authors.initials: A
authors.lastname: Welz
authors.forename: Friedhelm
authors.initials: F
authors.lastname: Saborowski
authors.forename: Berndt
authors.initials: B
authors.lastname: Lüderitz
authors.forename: Thorsten
authors.initials: T
authors.lastname: Lewalter
mesh_terms: D000465:Algorithms; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000503:physiopathology / Q000517:prevention & control* / Q000628:therapy; D002304:Cardiac Pacing, Artificial / Q000379:methods; D004562:Electrocardiography; D006801:Humans; D010138:Pacemaker, Artificial