title: Right atrial appendage versus Bachmann's bundle stimulation: a two-year comparative study of electrical parameters in myotonic dystrophy type-1 patients.
abstract: OBJECTIVE
  We performed a two-year follow-up comparative study of long-term electrical parameters between the right atrial appendage (RAA) and Bachmann's Bundle (BB) stimulation in myotonic dystrophy type 1 (MD1) patients.
  
  
  METHODS
  Twenty-five MD1 patients (18 men; age: 54 +/- 13 years) with no difference in the electrical parameters between the RAA site and the BB region at implantation were randomized into two groups: in group I (13 patients; age: 52 +/- 14 years; four women) the atrial lead was placed in the RAA and in group II (12 patients, age: 56 +/- 12 years, three women) the lead was placed in the BB region. Measurements of electrical parameters were recorded at follow-up intervals of 6 weeks and then 12 and 24 months postimplant.
  
  
  RESULTS
  There was no statistically significant different in P-wave amplitude, pacing threshold, and impedance values between the two groups at 6 weeks. At 24 months follow-up, the intrinsic P-wave amplitude was 2.05 +/- 1.45 mV in the RAA group versus 3.28 +/- 1.09 mV in the BB group (P < 0.05); the pacing threshold was 1.85 +/- 1.8 V in the RAA group versus 0.50 +/- 0.39 V in the BB group (P = 0.03); there were no differences in the atrial impedance between the two groups during the follow-up period.
  
  
  CONCLUSIONS
  In a direct two-year follow-up comparison between the RAA and BB atrial pacing sites, we showed a statistically significant increased pacing threshold and decreased intrinsic P-wave amplitude during RAA stimulation in MD1 patients.
authors.affiliation: Chair of Cardiology, Second University of Naples, Monaldi Hospital, Naples, Italy.
authors.forename: Gerardo
authors.initials: G
authors.lastname: Nigro
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Russo
authors.forename: Luisa
authors.initials: L
authors.lastname: Politano
authors.forename: Nadia
authors.initials: N
authors.lastname: Della Cioppa
authors.forename: Donatella
authors.initials: D
authors.lastname: Manfredi
authors.forename: Raffaele
authors.initials: R
authors.lastname: Chianese
authors.forename: Annabella
authors.initials: A
authors.lastname: De Chiara
authors.forename: Anna
authors.initials: A
authors.lastname: Rago
authors.forename: Giulia
authors.initials: G
authors.lastname: Arena
authors.forename: Alberto
authors.initials: A
authors.lastname: Palladino
authors.forename: Raffaele
authors.initials: R
authors.lastname: Calabrò
mesh_terms: D002037:Bundle-Branch Block / Q000175:diagnosis* / Q000517:prevention & control*; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D004562:Electrocardiography; D005260:Female; D006325:Heart Atria; D006801:Humans; D008297:Male; D008875:Middle Aged; D009223:Myotonic Dystrophy / Q000175:diagnosis* / Q000628:therapy*; D016896:Treatment Outcome