Suppression of intra-atrial reentrant tachycardia in patients with atrial overdrive pacing.
BACKGROUND
Intra-atrial reentrant tachycardia (IART) is a common arrhythmia in adult patients with palliated congenital heart disease (CHD). Traditional treatment methods such as antiarrhythmic drugs (AADs) or radiofrequency ablation are often unsuccessful or cause side effects. These patients often require frequent cardioversion and anticoagulation. The purpose of this study is to evaluate the success of overdrive atrial pacing for the suppression of IART in CHD.


METHODS
Single center, investigational review board approved, retrospective review of nine patients with CHD and documented, recurrent IART. Patients served as their own historical controls for this study. Phase I was defined as the period 2 years prior to atrial pacing intervention, and Phase II was defined as > or =13 months with atrial pacing; enabled or implanted rate responsive or dynamic overdrive A pacing. During Phase II, the patients' rhythm was monitored by either symptom reporting, ECG, Holter monitoring or pacer diagnostics every 2 months.


RESULTS
Cardioversion post A pacing decreased: from 25 to 3, P < .003, patients requiring cardioversions 9 to 1, P < .001, no. AADs 18 to 7, P < .02.


CONCLUSIONS
Overdrive atrial pacing, > or =70 ppm, is a viable treatment option to suppress recurrent IART. With the suppression of IART, the need for cardioversion, and AAD can be significantly reduced.
Department of Pediatrics, Ochsner Clinic Foundation, Section of Pediatric Cardiology, New Orleans, LA 70121, USA. csnyder@ochsner.org
Christopher S
CS
Snyder
Glen
G
Dobson
Nancy
N
Rollinson
Robert
R
Graumann
D000293:Adolescent; D000328:Adult; D002304:Cardiac Pacing, Artificial; D005260:Female; D006325:Heart Atria; D006330:Heart Defects, Congenital / Q000150:complications* / Q000601:surgery; D006801:Humans; D008297:Male; D010138:Pacemaker, Artificial; D012008:Recurrence; D012189:Retrospective Studies; D013615:Tachycardia, Sinoatrial Nodal Reentry / Q000209:etiology* / Q000628:therapy*; D016896:Treatment Outcome