Suppression of Atrial Fibrillation by Atrial Pacing

• Published in: Circulation Journal Vol. 70; no. 11; pp. 1398 - 1401
• Main Authors: Inoue, Noriko, Ishikawa, Toshiyuki, Sumita, Shinichi, Kobayashi, Tsukasa, Matsushita, Kohei, Matsumoto, Katsumi, Taima, Minoru, Shimura, Miei, Uchino, Kazuaki, Kimura, Kazuo, Umemura, Satoshi
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Circulation Society 2006
• Subjects: Aged; Atrial fibrillation; Atrial Fibrillation - epidemiology; Atrial Fibrillation - etiology; Atrial Fibrillation - physiopathology; Atrial Fibrillation - prevention & control; Cardiac Pacing, Artificial - methods; Electrophysiology; Female; Heart Block - complications; Heart Block - physiopathology; Heart Block - therapy; Heart Conduction System - physiopathology; Humans; Male; Middle Aged; Pacemaker; Pacing; Prevalence; Sick Sinus Syndrome - complications; Sick Sinus Syndrome - physiopathology; Sick Sinus Syndrome - therapy; Time Factors
• ISSN: 1346-9843; 1347-4820
• DOI: 10.1253/circj.70.1398

Background Atrial fibrillation (AF) is a common arrhythmia in patients with an implanted pacemaker, but the role of atrial pacing in preventing AF is still unclear. Methods and Results Sixty-six patients (67.8±12.1 years) were enrolled: 54 with sick sinus syndrome (SSS), 11 with atrioventricular blocks (AVB), and 1 with SSS and AVB. The prevalence of AF was investigated. In 22 patients with AF, the AF burden was estimated under "back-up pacing" (40-50 beats/min), then under "atrial pacing" (60-85 beats/min). The prevalence of AF in the SSS group tended to be higher than that in the AVB group (48.1% vs 18.2%, p=0.06). The AF burden in patients with a percentage of atrial pacing (% atrial pacing) <50% was significantly greater than that in patients with % atrial pacing ≥50% (12.5±21.1% vs 4.2±10.3%, p<0.05). AF disappeared immediately after "atrial pacing" in 4 patients (18.2%). In 9 patients (40.9%), the AF burden decreased gradually, and AF disappeared in 6 patients (27.3%) after 207.9±130.2 days. Conclusion The prevalence of AF may be higher in patients with SSS than in those with AVB. Atrial pacing has a preventive effect on AF, and the effect of atrial pacing is not always immediate but is progressive in some patients. (Circ J 2006; 70: 1398 - 1401)