Biatrial pacing improves atrial haemodynamics and atrioventricular timing compared with pacing from the right atrial appendage.

Details

Serval ID
serval:BIB_C2DF0319C6B7
Type
Article: article from journal or magazin.
Collection
Publications
Title
Biatrial pacing improves atrial haemodynamics and atrioventricular timing compared with pacing from the right atrial appendage.
Journal
Europace
Author(s)
Burri H., Bennani I., Domenichini G., Ganière V., Sunthorn H., Stettler C., Gentil P., Shah D.
ISSN
1532-2092 (Electronic)
ISSN-L
1099-5129
Publication state
Published
Issued date
09/2011
Peer-reviewed
Oui
Volume
13
Number
9
Pages
1262-1267
Language
english
Notes
Publication types: Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
Patients with interatrial conduction delay may have suboptimal left atrioventricular (AV) timing due to delayed contraction of the left atrium with foreshortening of ventricular filling. This may be an issue in pacemaker patients, especially those requiring resychronization therapy. Pacing from the high interatrial septum (IAS) or the distal or proximal coronary sinus (CSD and CSP) may improve left AV synchrony compared with pacing from the right atrial appendage (RAA). Our aim was to compare haemodynamics of these pacing sites.
A total of 24 patients undergoing radiofrequency ablation for paroxysmal atrial fibrillation were studied. Left atrial pressures were recorded in sinus rhythm, and during pacing from the RAA, IAS, CSD, CSP, and with biatrial (BiA) pacing from the IAS + CSD. Amplitudes, +dP/dT(max), and timing of the a-wave were compared between recordings. Left atrial contractility, measured by +dP/dT(max), was greatest during BiA pacing (P ≤ 0.03 for all comparisons). There was a marked reduction in delay to peak a-wave when pacing from all sites compared with the RAA, with BiA pacing yielding the shortest delay (P ≤ 0.001). However, AV conduction was shortened by all alternative pacing sites, which mitigated the anticipation of left atrial contraction with respect to ventricular activation, except for BiA pacing (P < 0.001). Pacing of the IAS did not result in any improvement in haemodynamics or AV synchrony.
Multisite atrial pacing results in favourable acute atrial haemodynamics and left AV synchrony. This may be a solution in pacemaker patients with interatrial conduction delay.
Keywords
Aged, Arrhythmias, Cardiac/physiopathology, Arrhythmias, Cardiac/surgery, Atrial Appendage/physiopathology, Atrial Appendage/surgery, Atrioventricular Block/physiopathology, Atrioventricular Block/surgery, Cardiac Pacing, Artificial/methods, Catheter Ablation, Female, Hemodynamics, Humans, Male, Middle Aged
Pubmed
Web of science
Open Access
Yes
Create date
03/03/2024 19:05
Last modification date
11/03/2024 8:17
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