Impact of the atrial lead pacing site regarding atrial fibrillation onset in patients with sinus node dysfunction

Pernollet, Patrice; Gras, Matthieu; Bidegain, Nicolas; Gal, François Le; Christiaens, Luc; Degand, Bruno; Garcia, Rodrigue

doi:10.1016/j.ijcard.2021.03.074

Cited by 1 publication

(2 citation statements)

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“…The lateral right atrial free wall is not a preferred site of atrial lead placement for clinicians, due to the risk of perforation of the right atrial lead in the very thin wall of the right atrium. However, Pernollet et al recently demonstrated that 4 years after pacemaker implantation, AF occurred in 26.6% of the RAA group and only 9.7% of the lateral group ( 22 ). Pacing at the right atrial lateral wall was associated with a significantly lower incidence of AF compared with conventional RAA pacing ( 22 ).…”

Section: Atrial Pacingmentioning

confidence: 99%

“…However, Pernollet et al recently demonstrated that 4 years after pacemaker implantation, AF occurred in 26.6% of the RAA group and only 9.7% of the lateral group ( 22 ). Pacing at the right atrial lateral wall was associated with a significantly lower incidence of AF compared with conventional RAA pacing ( 22 ). As described above, the PASTA trial did not detect a statistically significant difference in the incidence of AF between the four groups, including lateral right atrial wall, RAA, coronary sinus ostium, or dual-site right atrial pacing, after 24 months of follow-up ( 18 ).…”

Section: Atrial Pacingmentioning

confidence: 99%

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Pacemaker-induced atrial fibrillation reconsidered—associations with different pacing sites and prevention approaches

Kreimer,

Gotzmann

2024

Front. Cardiovasc. Med.

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The incidence of atrial fibrillation (AF) is significantly higher in patients with pacemakers than in the general population, which could be due to patient characteristics and the diagnostic tool of the pacemaker in detecting atrial high-rate episodes and subclinical AF, but also to the pacemaker itself providing AF-promoting conditions. It is well known that high ventricular pacemaker burden increases the likelihood of AF occurrence. However, the sites of atrial and ventricular pacing may also influence the risk for AF. The conventional sites for atrial and ventricular pacing are in the right atrial appendage and in the right ventricular apex. However, growing evidence suggests that alternative pacing sites may be superior for the prevention of AF. Bachmann bundle pacing, for example, promotes interatrial excitation conduction, resulting in atrial synchronicity and a shorter total atrial activation time, which may be preventive for the occurrence of AF. Moreover, in recent years, new ventricular pacing sites have come into focus with His bundle and left bundle branch pacing. In addition to the hemodynamic and electrophysiological cardiac benefits, these new options may also offer benefits in the prevention of AF. This review provides an overview of pacing-induced AF mechanisms and the association with different pacing sites, as well as approaches for prevention of pacing-induced AF, highlighting different sites and modes of atrial pacing and the newer sites of ventricular pacing.

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Section: Atrial Pacingmentioning

confidence: 99%