title: Impact of atrial antitachycardia pacing and atrial pace prevention therapies on atrial fibrillation burden over long-term follow-up.
abstract: OBJECTIVE
  Selective atrial pacing algorithms have been developed for prevention of atrial tachycardia/atrial fibrillation (AT/AF). Although short-term studies have shown modest to minimal incremental benefit of these algorithms compared with conventional dual-chamber (DDD/R) pacing for prevention of AT/AF, the long-term effects of these algorithms are unknown. Accordingly, we compared atrial antitachycardia pacing (ATP) therapy and combined atrial ATP and atrial pace prevention (ATP + Prevention) algorithms to conventional DDD/R pacing for prevention of AT/AF over long-term follow-up.
  
  
  RESULTS
  Seventy-one patients with AT/AF following pacemaker insertion were randomized to DDD/R pacing, DDD/R plus ATP pacing, or DDD/R plus ATP and prevention pacing and followed for 3 years. Atrial tachycardia/AF burden and an AF symptom scale were compared over time between groups. Atrial tachycardia/AF burden remained stable over 3 years in the DDD/R and ATP + Prevention groups. Atrial tachycardia/AF burden increased significantly over time in the ATP group. Patients not on class I or III antiarrhythmic drug therapy were more likely to experience an increase in AT/AF burden over time.
  
  
  CONCLUSIONS
  Atrial ATP and atrial ATP in combination with atrial pace prevention algorithms do not suppress AT/AF over long-term follow-up compared with DDD/R pacing.
authors.affiliation: Health Sciences Centre, Department of Cardiac Sciences, University of Calgary, Calgary Health Region, Rm. 1634, 3330 Hospital Dr. NW, Calgary, Alberta, Canada. amgillis@ucalgary.ca
authors.forename: Anne M
authors.initials: AM
authors.lastname: Gillis
authors.forename: Margaret
authors.initials: M
authors.lastname: Morck
authors.forename: Derek V
authors.initials: DV
authors.lastname: Exner
authors.forename: Robert S
authors.initials: RS
authors.lastname: Sheldon
authors.forename: Henry J
authors.initials: HJ
authors.lastname: Duff
authors.forename: Brent L
authors.initials: BL
authors.lastname: Mitchell
authors.forename: George D
authors.initials: GD
authors.lastname: Wyse
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications* / Q000517:prevention & control*; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D017180:Tachycardia, Ventricular / Q000150:complications* / Q000517:prevention & control*; D013813:Therapy, Computer-Assisted / Q000379:methods*