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  • Title: Impact of atrial antitachycardia pacing and atrial pace prevention therapies on atrial fibrillation burden over long-term follow-up.
    Author: Gillis AM, Morck M, Exner DV, Sheldon RS, Duff HJ, Mitchell BL, Wyse GD.
    Journal: Europace; 2009 Aug; 11(8):1041-7. PubMed ID: 19460849.
    Abstract:
    AIMS: Selective atrial pacing algorithms have been developed for prevention of atrial tachycardia/atrial fibrillation (AT/AF). Although short-term studies have shown modest to minimal incremental benefit of these algorithms compared with conventional dual-chamber (DDD/R) pacing for prevention of AT/AF, the long-term effects of these algorithms are unknown. Accordingly, we compared atrial antitachycardia pacing (ATP) therapy and combined atrial ATP and atrial pace prevention (ATP + Prevention) algorithms to conventional DDD/R pacing for prevention of AT/AF over long-term follow-up. METHODS AND RESULTS: Seventy-one patients with AT/AF following pacemaker insertion were randomized to DDD/R pacing, DDD/R plus ATP pacing, or DDD/R plus ATP and prevention pacing and followed for 3 years. Atrial tachycardia/AF burden and an AF symptom scale were compared over time between groups. Atrial tachycardia/AF burden remained stable over 3 years in the DDD/R and ATP + Prevention groups. Atrial tachycardia/AF burden increased significantly over time in the ATP group. Patients not on class I or III antiarrhythmic drug therapy were more likely to experience an increase in AT/AF burden over time. CONCLUSION: Atrial ATP and atrial ATP in combination with atrial pace prevention algorithms do not suppress AT/AF over long-term follow-up compared with DDD/R pacing.
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