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Published in: Netherlands Heart Journal 1/2008

01-01-2008 | article

Clinical application of pacemakers in atrial tachyarrhythmias

Authors: W. G. de Voogt, N. M. van Hemel

Published in: Netherlands Heart Journal | Issue 1/2008

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Extract

In principle, pacemakers (PM) are indicated for the treatment of bradycardia-related symptoms and nowadays also for the resynchronisation of the failing left ventricle. In sick sinus syndrome, atrial tachyarrhythmias (ATAs) frequently emerge. Experience shows that the hybrid approach of standard atrial pacing with AAI(R) or DDD(R) and pharmacological treatment is useful to suppress ATAs in sick sinus syndrome. These results, the growing number of patients with ATAs with different aetiologies and the limited (long-term) success rates of catheter ablative methods of the source of ATAs, recently triggered the technical development of pacing algorithms. These recognise, classify and diagnose ATAs and deliver specific atrial pacing sequences for preventing and/or interrupting ATAs. Recent large-scale studies demonstrate ambiguous results, but all show that additional pharmacological treatment remains indispensable in obtaining benefit. This overview addresses some characteristics of these pacing algorithms, including PM diagnostics and programming as well as discusses the role of the atrial pacing site and configuration of atrial pacing leads. …
Literature
1.
go back to reference Israel CW, Barold SS. Pacemaker systems as implantable cardiac rhythm monitors. Am J Cardio l2001;88:442-5. Israel CW, Barold SS. Pacemaker systems as implantable cardiac rhythm monitors. Am J Cardio l2001;88:442-5.
2.
go back to reference de Voogt WG, van Hemel NM, van de Bos AA, Koistinen J, Fast JH. Verification of pacemaker automatic mode switching for the detection of atrial fibrillation and atrial tachycardia with Holter recording. Europace 2006;8:950-61. de Voogt WG, van Hemel NM, van de Bos AA, Koistinen J, Fast JH. Verification of pacemaker automatic mode switching for the detection of atrial fibrillation and atrial tachycardia with Holter recording. Europace 2006;8:950-61.
3.
go back to reference Israel CW, Barold SS. Failure of atrial flutter detection by a pacemaker with a dedicated atrial flutter detection algorithm. Pacing Clin Electrophysiol 2002;25:1274-7. Israel CW, Barold SS. Failure of atrial flutter detection by a pacemaker with a dedicated atrial flutter detection algorithm. Pacing Clin Electrophysiol 2002;25:1274-7.
4.
go back to reference Goethals M, Timmermans W, Geelen P, Backers J, Brugada P. Mode switching failure during atrial flutter: the ‘2:1 lock-in’ phenomenon. Europace 2003;5:95-102. Goethals M, Timmermans W, Geelen P, Backers J, Brugada P. Mode switching failure during atrial flutter: the ‘2:1 lock-in’ phenomenon. Europace 2003;5:95-102.
5.
go back to reference de Voogt W, van Hemel N, Willems A, Visser J, Chitre Y, Bornzin G, et al. Far-field R-wave reduction with a novel lead design: experimental and human results. Pacing Clin Electrophysiol 2005;28:782-8. de Voogt W, van Hemel N, Willems A, Visser J, Chitre Y, Bornzin G, et al. Far-field R-wave reduction with a novel lead design: experimental and human results. Pacing Clin Electrophysiol 2005;28:782-8.
6.
go back to reference van Hemel NM, Wohlgemuth P, Engbers JG, Lawo T, Nebaznivy J, Taborsky M, et al. Form analysis using digital signal processing reliably discriminates far-field R waves from P waves. Pacing Clin Electrophysiol 2004;27:1615-24. van Hemel NM, Wohlgemuth P, Engbers JG, Lawo T, Nebaznivy J, Taborsky M, et al. Form analysis using digital signal processing reliably discriminates far-field R waves from P waves. Pacing Clin Electrophysiol 2004;27:1615-24.
7.
go back to reference Guyomar Y, Thomas O, Marquie C, Jarwe M, Klug D, Kacet S, et al. Mechanisms of onset of atrial fibrillation: a multicenter, prospective, pacemaker-based study. Pacing Clin Electrophysiol 2003;26:1336-41. Guyomar Y, Thomas O, Marquie C, Jarwe M, Klug D, Kacet S, et al. Mechanisms of onset of atrial fibrillation: a multicenter, prospective, pacemaker-based study. Pacing Clin Electrophysiol 2003;26:1336-41.
8.
go back to reference Waldo AL, Feld GK. Inter-relationships of atrial fibrillation and atrial flutter mechanisms and clinical implications. J Am Coll Cardiol 2008;51:779-86. Waldo AL, Feld GK. Inter-relationships of atrial fibrillation and atrial flutter mechanisms and clinical implications. J Am Coll Cardiol 2008;51:779-86.
9.
go back to reference Bailin SJ, Adler S, Giudici M. Prevention of chronic atrial fibrillation by pacing in the region of Bachmann's bundle: results of a multicenter randomized trial. J Cardiovasc Electrophysiol 2001;12:912-7. Bailin SJ, Adler S, Giudici M. Prevention of chronic atrial fibrillation by pacing in the region of Bachmann's bundle: results of a multicenter randomized trial. J Cardiovasc Electrophysiol 2001;12:912-7.
10.
go back to reference Padeletti L, Pieragnoli P, Ciapetti C, Colella A, Musilli N, Porciani MC, et al. Randomized crossover comparison of right atrial appendage pacing versus interatrial septum pacing for prevention of paroxysmal atrial fibrillation in patients with sinus bradycardia. Am Heart J 2001;142:1047-55. Padeletti L, Pieragnoli P, Ciapetti C, Colella A, Musilli N, Porciani MC, et al. Randomized crossover comparison of right atrial appendage pacing versus interatrial septum pacing for prevention of paroxysmal atrial fibrillation in patients with sinus bradycardia. Am Heart J 2001;142:1047-55.
11.
go back to reference de Voogt WG, Van Mechelen R, Van Den BA, Scheffer M, van Hemel NM, Koistinen J. A technique of lead insertion for low atrial septal pacing. Pacing Clin Electrophysiol 2005;28:639-46. de Voogt WG, Van Mechelen R, Van Den BA, Scheffer M, van Hemel NM, Koistinen J. A technique of lead insertion for low atrial septal pacing. Pacing Clin Electrophysiol 2005;28:639-46.
12.
go back to reference Padeletti L, Santini M, Boriani G, Botto G, Ricci R, Spampinato A, et al. Duration of P-wave is associated with atrial fibrillation hospitalizations in patients with atrial fibrillation and paced for bradycardia. Pacing Clin Electrophysiol 2007;30:961-9. Padeletti L, Santini M, Boriani G, Botto G, Ricci R, Spampinato A, et al. Duration of P-wave is associated with atrial fibrillation hospitalizations in patients with atrial fibrillation and paced for bradycardia. Pacing Clin Electrophysiol 2007;30:961-9.
13.
go back to reference Padeletti L, Purerfellner H, Adler SW, Waller TJ, Harvey M, Horvitz L, et al. Combined efficacy of atrial septal lead placement and atrial pacing algorithms for prevention of paroxysmal atrial tachyarrhythmia. J Cardiovasc Electrophysiol 2003;14:1189-95. Padeletti L, Purerfellner H, Adler SW, Waller TJ, Harvey M, Horvitz L, et al. Combined efficacy of atrial septal lead placement and atrial pacing algorithms for prevention of paroxysmal atrial tachyarrhythmia. J Cardiovasc Electrophysiol 2003;14:1189-95.
14.
go back to reference De Voogt W, Van Hemel N, de Vusser P, Mairesse GH, Van Mechelen R, Koistinen J, et al. No evidence of automatic atrial overdrive pacing efficacy on reduction of paroxysmal atrial fibrillation. Europace 2007;9:798-804. De Voogt W, Van Hemel N, de Vusser P, Mairesse GH, Van Mechelen R, Koistinen J, et al. No evidence of automatic atrial overdrive pacing efficacy on reduction of paroxysmal atrial fibrillation. Europace 2007;9:798-804.
15.
go back to reference Lellouche N, De Diego C, Vaseghi M, Buch E, Cesario DA, Mahajan A, et al. Cardiac resynchronization therapy response is associated with shorter duration of atrial fibrillation. Pacing Clin Electrophysiol 2007;30:1363-8. Lellouche N, De Diego C, Vaseghi M, Buch E, Cesario DA, Mahajan A, et al. Cardiac resynchronization therapy response is associated with shorter duration of atrial fibrillation. Pacing Clin Electrophysiol 2007;30:1363-8.
16.
go back to reference Padeletti L, Musilli N, Porciani MC, Colella A, Di Biase L, Ricciardi G, et al. Atrial fibrillation and cardiac resynchronization therapy: the MASCOT study. Europace 2004;5(Suppl 1):S49-S54. Padeletti L, Musilli N, Porciani MC, Colella A, Di Biase L, Ricciardi G, et al. Atrial fibrillation and cardiac resynchronization therapy: the MASCOT study. Europace 2004;5(Suppl 1):S49-S54.
Metadata
Title
Clinical application of pacemakers in atrial tachyarrhythmias
Authors
W. G. de Voogt
N. M. van Hemel
Publication date
01-01-2008
Publisher
Bohn Stafleu van Loghum
Published in
Netherlands Heart Journal / Issue 1/2008
Print ISSN: 1568-5888
Electronic ISSN: 1876-6250
DOI
https://doi.org/10.1007/BF03086200

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