Year: 2001
Type: article
Abstract: ∑ The development of atrial pacing for prevention of drug refractory atrial fibrillation was a logical step in the management of this arrhythmia.The electrophysiologic rationale for the efficacy of atrial pacing is based on the reduction of global and local atrial activation times during pacing, which results in reduced dispersion of atrial refractoriness and decreased interatrial conduction delay.However, the atrial pacing strategy should be considered in different populations with atrial fibrillation.To date, there is increasing evidence that single site atrial pacing is beneficial for atrial fibrillation prevention in patients with sick sinus syndrome.Both dual-site right atrial and interatrial septal pacing have an incremental benefit as compared with single-site right atrial pacing, and can be used in selected patients with resistant symptomatic atrial fibrillation, especially if they have prolonged interatrial conduction.The efficacy of biatrial pacing is still unproven, and technically is associated with frequent coronary sinus lead dislodgment.Further studies with multi-site atrial pacing and new algorithms for atrial fibrillation prevention are needed, possibly in combination with antiarrhythmic drug therapy or ablation, which should expand the use of atrial stimulation in the treatment of symptomatic atrial fibrillation.
Authors: Dubravko Petrač, Vladimira Leskovar
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2204806077