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Prevention of paroxysmal atrial fibrillation by permanent septal atrial pacing: long-term follow up

L. Padeletti*, P. Pieragnoli, C. Ciapetti, A. Colefa, N. Musilli, M.C. Porciani, A. Michelucci and G.F. Gensini

Institute of Internal Medicine and Cardiology, University of Florence, Florence, Italy

* Correspondence: Luigi Padeletti, MD, Institute of Internal Medicine and Cardiology, University of Florence, Viale Morgagni 85, 50134 Florence, Italy.

Abstract

Background Inter-atrial septum pacing may prevent initiation or persistence of atrial fibrillation through suppression of premature beats and regularization of atrial rhythm; prolongation of the coupling interval of the premature beats in the abnormal substrate; and modification of the electrophysiological properties of the substrate. The aim of the present study was to evaluate the rate of progression to permanent atrial fibrillation in patients paced at the inter-atrial septum.

Method A total of 70 patients (41 male, 29 female; mean age 72 ± 11 years) with a history of sinus bradycardia and paroxysmal atrial fibrillation (6 ± 10 episodes/month in the 3 months before implantation of a pacemaker) were enrolled. Twenty-six patients were ablated at the atrioventricular junction.

Results Sinus rhythm was maintained in 79.8% of the group overall after 50 months. After 36 months, sinus rhythm was maintained in 87.9% of the non-ablated patients and in 61.0% of the ablated patients ().

Conclusion These results encourage further evaluation of interatrial septum pacing for prevention of AF.

Key Words: Atrial fibrillation • sinus bradycardia • septal atrial pacing • atrioventricular node ablation

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