Ricci R, Santini M, Puglisi A, Azzolini P, Capucci A, Pignalberi C, Boriani G, Botto G L, Spampinato A, Bellocci F, Proclemer A, Grammatico A, de Seta F
San Filippo Neri Hospital, Rome, Italy.
J Interv Card Electrophysiol. 2001 Mar;5(1):33-44. doi: 10.1023/a:1009801706928.
The Consistent Atrial Pacing (CAP) algorithm has been designed to achieve a high percentage of atrial pacing to suppress paroxysmal atrial fibrillation. The aim of our study was to compare the impact of DDDR+CAP versus DDDR pacing on paroxysmal atrial fibrillation recurrences and triggers in patients with Brady-Tachy Syndrome.
61 patients, 23 M and 38 F, mean age 75+/-9 y, affected by Brady-Tachy Syndrome, implanted with a DDDR pacemaker, were randomized to DDDR or DDDR+CAP pacing with cross over of pacing modality after 1 month.
78 % of patients in DDDR pacing and 73 % in DDDR + CAP pacing (p=n.s.) were free from symptomatic paroxysmal atrial fibrillation recurrences. During DDDR+CAP pacing, the atrial pacing percentage increased from 77+/-29 % to 96+/-7 % (p<0.0001). Automatic mode switch episodes/day were 0.73+/-1.09 in DDDR and 0.79+/-1.14 (p=n.s.) in DDDR+CAP. In patients with less than 50 % of atrial pacing during DDDR, automaticmode switch episodes/day decreased during DDDR+CAP from 1.13+/-1.59 to 0.23+/-0.32 (p<0.05) and in patients with less than 90 % from 1.23+/-1.27 to 0.75+/-1.10 (p<0.001). The number of premature atrial complexes per day decreased during DDDR + CAP from 2665+/-4468 to 556+/-704 (p<0.02).
CAP algorithm allowed continuous overdrive atrial pacing without major side effects. Triggers of paroxysmal atrial fibrillation induction, such as premature atrial complexes, were critically decreased. Paroxysmal atrial fibrillation episodes were reduced in patients with atrial pacing percentage lower than 90 % during DDDR pacing.
持续性心房起搏（CAP）算法旨在实现高比例的心房起搏以抑制阵发性心房颤动。我们研究的目的是比较双腔按需起搏（DDDR）+CAP与DDDR起搏对缓速综合征患者阵发性心房颤动复发及触发因素的影响。
61例缓速综合征患者（23例男性，38例女性，平均年龄75±9岁）植入了DDDR起搏器，随机分为DDDR起搏组或DDDR+CAP起搏组，1个月后交叉起搏模式。
DDDR起搏组78%的患者和DDDR+CAP起搏组73%的患者（p=无统计学意义）无有症状的阵发性心房颤动复发。在DDDR+CAP起搏期间，心房起搏百分比从77±29%增加到96±7%（p<0.0001）。DDDR组每天自动模式转换发作次数为0.73±1.09，DDDR+CAP组为0.79±1.14（p=无统计学意义）。在DDDR期间心房起搏低于50%的患者中，DDDR+CAP期间每天自动模式转换发作次数从1.13±1.59降至0.23±0.32（p<0.05），在低于90%的患者中从1.23±1.27降至0.75±1.10（p<0.001）。DDDR+CAP期间每天房性早搏数量从2665±4468降至556±704（p<0.02）。
CAP算法允许持续超速心房起搏且无主要副作用。阵发性心房颤动诱发的触发因素，如房性早搏，显著减少。在DDDR起搏期间心房起搏百分比低于90%的患者中，阵发性心房颤动发作减少。
