title: 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.affiliation: Institute of Internal Medicine and Cardiology, University of Florence, Florence, Italy. elettrofisiologia@dac.unifi.it
authors.forename: Luigi
authors.initials: L
authors.lastname: Padeletti
authors.forename: Antonio
authors.initials: A
authors.lastname: Michelucci
authors.forename: Paolo
authors.initials: P
authors.lastname: Pieragnoli
authors.forename: Andrea
authors.initials: A
authors.lastname: Colella
authors.forename: Nicola
authors.initials: N
authors.lastname: Musilli
mesh_terms: D000818:Animals; D001281:Atrial Fibrillation / Q000503:physiopathology / Q000517:prevention & control*; D001919:Bradycardia / Q000517:prevention & control; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D022062:Electrophysiologic Techniques, Cardiac; D006325:Heart Atria; D006346:Heart Septum; D006801:Humans; D010138:Pacemaker, Artificial