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  • Title: Effects of continuous and triggered atrial overdrive pacing on paroxysmal atrial fibrillation in pacemaker patients.
    Author: Schuchert A, Rebeski HP, Peiffer T, Bub E, Dietz A, Mortensen K, Aydin MA, Camm J, Gazarek S, Meinertz T, 3:4 Study Group.
    Journal: Pacing Clin Electrophysiol; 2008 Aug; 31(8):929-34. PubMed ID: 18684247.
    Abstract:
    BACKGROUND: The aim of the study was to compare the effects of different pacing strategies to prevent paroxysmal atrial fibrillation (AF): triggered atrial overdrive pacing versus the combination of triggered and continuous overdrive pacing. METHODS: Patients with an indication for dual-chamber pacing (Selection 9000, Prevent AF; Vitatron B.V., Arnhem, the Netherlands) and a history of paroxysmal AF were randomized to triggered atrial pacing (three pacing functions, "triggered group": PAC Suppression, Post-PAC Response, and Post-Exercise Response) or to the combination of continuous (Pace Conditioning) and triggered atrial pacing (four pacing functions, "combined group"). After 3 months, there was a crossover to the other pacemaker setting. RESULTS: In 171 enrolled patients, the median AF burden of the combined group was with 2.1% versus 0.1% in the triggered group (P = 0.014). Fewer AF episodes were observed in the triggered (median: 7) than in the combined group (median: 116; P = 0.016). The combined group had more frequent atrial pacing (median 97%) than the triggered group with 85% (P < 0.001), but ventricular pacing was not significantly different with 95% and 96% in the combined and triggered group, respectively. After the crossover, the AF burden increased in the triggered group to 0.3% and decreased in the combined group to 0.4%. CONCLUSIONS: Triggered atrial pacing functions alone resulted in a low AF burden. The additional activation of continuous atrial overdrive pacing increased the percentage of atrial pacing, but had no beneficial effects on the prevention of paroxysmal AF.
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