Suppression of atrial fibrillation by atrial pacing.
BACKGROUND
Atrial fibrillation (AF) is a common arrhythmia in patients with an implanted pacemaker, but the role of atrial pacing in preventing AF is still unclear.


RESULTS
Sixty-six patients (67.8+/-12.1 years) were enrolled: 54 with sick sinus syndrome (SSS), 11 with atrioventricular blocks (AVB), and 1 with SSS and AVB. The prevalence of AF was investigated. In 22 patients with AF, the AF burden was estimated under "back-up pacing" (40-50 beats/min), then under "atrial pacing" (60-85 beats/min). The prevalence of AF in the SSS group tended to be higher than that in the AVB group (48.1% vs 18.2%, p=0.06). The AF burden in patients with a percentage of atrial pacing (% atrial pacing) <50% was significantly greater than that in patients with % atrial pacing >or=50% (12.5+/-21.1% vs 4.2+/-10.3%, p<0.05). AF disappeared immediately after "atrial pacing" in 4 patients (18.2%). In 9 patients (40.9%), the AF burden decreased gradually, and AF disappeared in 6 patients (27.3%) after 207.9+/-130.2 days.


CONCLUSIONS
The prevalence of AF may be higher in patients with SSS than in those with AVB. Atrial pacing has a preventive effect on AF, and the effect of atrial pacing is not always immediate but is progressive in some patients.
Inoue
Noriko
N
Department of Medical Science and Cardiorenal Medicine Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan. norikok@yokohama-cu.ac.jp
Ishikawa
Toshiyuki
T
Sumita
Shinichi
S
Kobayashi
Tsukasa
T
Matsushita
Kohei
K
Matsumoto
Katsumi
K
Taima
Minoru
M
Shimura
Miei
M
Uchino
Kazuaki
K
Kimura
Kazuo
K
Umemura
Satoshi
S
D000368:Aged; D001281:Atrial Fibrillation / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D004594:Electrophysiology; D005260:Female; D006327:Heart Block / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D006329:Heart Conduction System / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012804:Sick Sinus Syndrome / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D013997:Time Factors