Impact of anti-tachycardia pacing on atrial fibrillation burden when added on top of preventive pacing algorithms: results of the prevention or termination (POT) trial.
OBJECTIVE
The efficacy of preventive pacing algorithms (PPA) and anti-tachycardia pacing (ATP) in reducing atrial fibrillation (AF) burden remains controversial. The aim of this study was to assess whether ATP on top of PPA decreases AF burden.


RESULTS
A series of 199 consecutive patients, with conventional indications for pacing, and documented AF, received a DDDR (rate adaptive dual chamber pacemaker) pacemaker with ATP capabilities (AT 500 Medtronic). After 3 months of conventional DDDR pacing at 70 b.p.m., AF burden was analysed. If patients had >30 min/week of AF, they were randomized to PPA or to PPA+ATP for 3 months (period 1). They were then crossed to the alternative therapy (period 2) and followed three additional months with a 1-month wash out period in-between. A group of 85 patients were randomized. Mean age 68 +/- 8 years, 61% men. Both groups showed a significant decrease in AF burden at the end of period 1 (64 and 81%, respectively).


CONCLUSIONS
Atrial pacing with PPA decreases AF burden in patients with pacing indication. We did not observe a further decrease in AF burden or in the number of episodes when adding ATP on top of PPA.
Mont
Lluís
L
Thorax Institute, Hospital Clinic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Villarroel 170, Barcelona 08036, Catalonia, Spain. lmont@clinic.ub.es
Ruiz-Granell
Ricardo
R
Martínez
Juan Gabriel
JG
Carmona
José Ramon
JR
Fidalgo
Marisa
M
Cobo
Erik
E
Riera
Mireia
M
Navarro
Xavier
X
D000368:Aged; D000465:Algorithms; D001281:Atrial Fibrillation / Q000503:physiopathology / Q000517:prevention & control* / Q000628:therapy*; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D011446:Prospective Studies; D016037:Single-Blind Method; D013610:Tachycardia / Q000503:physiopathology / Q000517:prevention & control* / Q000628:therapy*; D016896:Treatment Outcome