https://scholars.lib.ntu.edu.tw/handle/123456789/188103
Title: | Dual-Site Atrial Pacing for Atrial Fibrillation in Patients without Bradycardia | Authors: | Lau, Chu-Pak Tse, Hung-Fat Yu, Cheuk-Man Teo, Wee-Siong Kam, Ruth Ng, Kheng-Siang Huang, Stephen Shoei K JIUNN-LEE LIN Fitts, Stephanie M Hettrick, Douglas A Hill, Michael R.S |
Keywords: | QUALITY-OF-LIFE;PREVENTION;CHAMBER;FLUTTER;TRIAL | Issue Date: | 2001 | Journal Volume: | 88 | Journal Issue: | 4 | Start page/Pages: | 371 | Source: | AMERICAN JOURNAL OF CARDIOLOGY | Abstract: | Atrial pacing has been shown to delay the onset of atrial fibrillation ( AF) when compared with ventricular pacing in patients with sick sinus syndrome. The role for pacing in the control of AF in patients without bradycardia is uncertain. We performed a randomized, crossover, single- blinded study in 22 patients (14 women, aged 63 +/- 10 years ) with paroxysmal AF refractory to treatment with oral sotalol (202 +/- 68 mg/day ) and no bradycardic indication for pacing. All patients received a dual- chamber pacemaker with 2 atrial pacing leads positioned at the high right atrium and coronary sinus ostium, respectively. Patients were randomized in a crossover fashion to be paced for 12 weeks, either with high right atrial (RA) pacing at 30 beats /min ("Off") or dual-site RA pacing with an overdrive algorithm that maintained atrial pacing at a rate slightly above the sinus rate ("On"). Treatment on resulted in a significantly higher percentage of atrial pacing and a reduction in atrial ectopic frequency than the treatment off period. The time to the first clinical AF recurrence was prolonged (15 +/- 17 to 50 +/- 35 days, p = 0.006), and total AF burden was reduced (45 +/- 34% vs 22 +/- 29%, p = 0 .04) in the on-treatment phase. However, there was no difference in AF checklist symptom scores or overall quality -of-life measures. Dual-site RA pacing with continued sinus overdrive prolonged the time to AF recurrence and decreased AF burden in patients with paroxysmal AF. The absence of a major impact on symptom control suggests that pacing should be used as an adjunctive therapy with other treatment modalities for AF. (C) 2001 by Excerpta Medica, Inc. |
URI: | http://ntur.lib.ntu.edu.tw//handle/246246/95150 https://www.scopus.com/record/display.uri?eid=2-s2.0-0035880614&doi=10.1016%2fS0002-9149%2801%2901681-2&origin=inward&txGid=835612fb895ce17edaf1f386f776ac7f |
DOI: | 10.1016/S0002-9149(01)01681-2 |
Appears in Collections: | 醫學系 |
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