International Heart Journal
Online ISSN : 1349-3299
Print ISSN : 1349-2365
ISSN-L : 1349-2365
Clinical Studies
Efficacy of Consistent Atrial Pacing Algorithm for Suppression of Atrial Arrhythmias in Patients With Sick Sinus Syndrome and Atrial Fibrillation
Yuko Miki, Toshiyuki Ishikawa, Noriko Inoue, Youhei Yamakawa, Tsukasa Kobayashi, Kohei Matsushita, Katsumi Matsumoto, Minoru Taima, Masami Kosuge, Shinichi Sumita, Kazuaki Uchino, Kazuo Kimura, Satoshi Umemura
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Keywords: Atrial preference pacing (APP) algorithm, Atrial arrhythmias, Atrial pacing, Atrial premature beat, Premature atrial complexes (PACs), Tachycardia-bradycardia syndrome, Sick sinus syndrome, Paroxysmal atrial fibrillation, Mode switch, DDDR pacemaker, Holter function
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2008 Volume 49 Issue 3 Pages 273-280

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Abstract

Atrial overdrive provides the best opportunity to suppress atrial arrhythmias. Atrial preference pacing (APP) algorithm has been designed to achieve a high percentage of atrial pacing. The aim of this study was to assess the efficacy of APP algorithm in patients with implanted pacemakers and tachycardia-bradycardia syndrome.
The subjects were 17 patients (mean age, 71.7 ± 9.0 years old, 4 males) implanted with a DDDR pacemaker Thera DR (Medtronic, Minneapolis, MN, USA). All patients had sick sinus syndrome and paroxysmal atrial fibrillation before pacemaker implantation. Informed consent was obtained from each participant before enrollment. DDDR and mode switch or APP were randomly programmed. After two weeks, the pacing mode was switched to another mode. The percentage of atrial pacing was significantly higher in APP than in DDDR (97.7 ± 1.4 versus 52.3 ± 30.8, P < 0.0001). Atrial premature beat counts were significantly greater in DDDR than in APP (30689 ± 42534 versus 7717 ± 10700, P < 0.005). There was no significant difference in mode switch episode counts between DDIR and APP (2.6 ± 5.5 versus 8.4 ± 19.2, NS).
Although there was no significant difference in mode switch episode counts between DDDR and APP, APP algorithm can successfully prevent atrial premature beats in patients with tachycardia-bradycardia syndrome.

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© 2008 by the International Heart Journal Association
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