Corbisiero Raffaele, Zazzali Kathleen, Muller David
Deborah Heart and Lung Center, Department of Cardiology, Electrophysiology Division 200 Trenton Road, Browns Mills, NJ 08015.
J Atr Fibrillation. 2013 Dec 31;6(4):856. doi: 10.4022/jafib.856. eCollection 2013 Dec.
Bi-atrial lead placement combined with atrial overdrive pacing has demonstrated a reduction in percent time mode switched and mode switches per day. This retrospective analysis compared long term outcomes of patients with right atrial overdrive pacing alone (DAO) to patients having atrial overdrive with bi-atrial leads (BIA) in slowing the progression of paroxysmal atrial fibrillation (PAF) to permanent continuous atrial fibrillation (CAF). Thirty-three patients age 76.6 (+/-1.96) from our prior investigation were selected. The DAO control group (N=16) had received a standard right atrial pacing lead. The BIA group (N=17) had pacing leads placed in the right atrium and coronary sinus. Patients were followed for a mean 1217 days (+/-838). Days of CAF was classified as the date of final mode switch until analysis. A total of 40,171 follow-up days were evaluated. The mean follow-up for both cohorts was 1217 days (+/-838). The DAO group consisted of 15,318 days (mean 957 +/-761) and the BIA group 24,853 days (mean 1461 +/-854). A lower total number of days were spent in CAF in the BIA group versus the DAO group, 1380 vs 2197 respectively. Corrected for follow-up duration, 5.55% days in CAF was seen in the BIA group vs. 14.34% in the DAO group which did not reach statistical significance. Although BIA overdrive pacing initially demonstrated reduced time in mode switch compared to DAO alone, this analysis did not detect a reduction in progression to CAF. More subjects or a longer follow up would be needed.
双心房电极植入联合心房超速起搏已显示模式转换时间百分比和每日模式转换次数有所减少。这项回顾性分析比较了单纯右心房超速起搏（DAO）患者与双心房电极进行心房超速起搏（BIA）患者在减缓阵发性心房颤动（PAF）进展为永久性持续性心房颤动（CAF）方面的长期结局。从我们之前的研究中选取了33名年龄为76.6（±1.96）岁的患者。DAO对照组（N = 16）接受了标准的右心房起搏电极。BIA组（N = 17）的起搏电极植入了右心房和冠状窦。患者平均随访1217天（±838）。CAF天数被定义为直至分析时的最后模式转换日期。共评估了40171个随访日。两个队列的平均随访时间均为1217天（±838）。DAO组为15318天（平均957±761），BIA组为24853天（平均1461±854）。与DAO组相比，BIA组在CAF中度过的总天数更少，分别为1380天和2197天。校正随访持续时间后，BIA组CAF天数占5.55%，DAO组为14.34%，未达到统计学显著性。尽管与单纯DAO相比，BIA超速起搏最初显示模式转换时间减少，但该分析未检测到进展为CAF的情况有所减少。需要更多的受试者或更长时间的随访。
