Atrial pacing for prevention of atrial fibrillation: assessment of simultaneously implemented algorithms

Abstract

When compared with DDD pacing at 70 bpm, ATA prevention algorithms have not demonstrated significant efficacy. However, a subgroup of patients with preserved native AV conduction (low percentage of ventricular pacing) responded to ATA prevention algorithms.

ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation

“…807,808 On the other hand, studies in patients with intermittent atrial tachyarrhythmias failed to illustrate a general benefit of atrial pacing. 808,822,897 Another potential avenue for primary prevention has been suggested following secondary analysis of placebo-controlled trials of treatment with ACE inhibitors. 36,749 In the LIFE 41 and CHARM 898 trials, the angiotensin receptor antagonists losartan and candesartan reduced the incidence of AF in hypertensive patients with LVH 41 and symptomatic HF, 40,898 respectively.…”

ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation—Executive Summary

“…359,360 On the other hand, studies in patients with intermittent atrial tachyarrhythmias failed to illustrate a general benefit of atrial pacing. 360,365,366 Another potential avenue for primary prevention has been suggested following secondary analysis of placebo-controlled trials of treatment with ACE inhibitors. 56,367 In the LIFE (Losartan Intervention For End Point Reduction in Hypertension) 16 and CHARM (Candesartan in Heart Failure Assessment of Reduction in Mortality and Morbidity) 368 trials, the angiotensin receptor antagonists losartan and candesartan reduced the incidence of AF in hypertensive patients with LVH 16 and symptomatic HF, 21,368 respectively.…”

2013 ESC Guidelines on Cardiac Pacing and Cardiac Resynchronization Therapy

“…Además, algunos dispositi- vos han incorporado algoritmos de estimulación cardiaca auricular antitaquicárdica (EAT) (gradiente de ritmo alto y estimulación cardiaca por descarga) para la terminación de la taquicardia auricular o el flutter auricular que podría degenerar en FA. Después del importante estudio multicéntrico de Israel et al 149 , se llevaron a cabo varios estudios aleatorizados que mostraron que los algoritmos preventivos tenían un beneficio incremental mínimo o nulo en la prevención de FA (tabla 20) [150][151][152][153][154][155][156][157][158][159] . En el más amplio de estos estudios 153,154 , se aleatorizó a 2.343 pacientes con hipertensión y sin antecedentes de FA a los que se implantó marcapasos o desfibrilador a recibir o no sobrestimulación auricular continua, lo que no evitó la FA o el resultado clínico de accidente cerebrovascular, embolia sisté-mica, infarto de miocardio, muerte por causas vasculares u hospitalización por IC.…”