Interatrial Septum Pacing Decreases Atrial Dyssynchrony on Strain Rate Imaging Compared with Right Atrial Appendage Pacing

Yasuoka, Yoshinori; Abe, Haruhiko; Umekawa, Seiko; Katsuki, Keiko; Tanaka, Norio; Araki, Ryo; Imanaka, Tadayuki; Matsutera, Ryo; Morisawa, Daisuke; Kitada, Hirokazu; Hattori, Satoshi; Noda, Yoshiki; Adachi, Hidenori; Sasaki, Tatsuya; Miyatake, Kunio

doi:10.1111/j.1540-8159.2010.02976.x

Cited by 8 publications

(5 citation statements)

References 31 publications

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“…AV optimization tended to improve left atrial function, measured by colour Doppler mitral annular late diastolic peak velocity. These results are concordant with the findings of Yasuoka et al 13 . Improvement of left atrial function was more pronounced in patients with a significant IACD (defined as an IAMD > 60 ms), which might be considered as a predictor of echocardiographic responsiveness to AV optimization.…”

Section: Other Outcome Measuressupporting

confidence: 83%

Clinical benefit of atrio-ventricular delay optimization in patients with a dual-chamber pacemaker: a pilot study. The CBRAVO trial (NCT01998256)

et al. 2016

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Objective Outcome data on exercise capacity following atrio-ventricular (AV) optimization of dual-chamber pacing are sparse. Pacemaker settings are often left at manufacturers' nominal values upon implantation. We studied the short-term effect of AV optimization on exercise capacity in patients with a dual-chamber pacemaker. Methods and resultsTwenty-eight patients (mean age 73 ± 14 y) with a dual-chamber pacemaker, were randomized towards either nominal AV settings (group 1) or echo-guided AV optimization using the iterative mitral inflow VTI (velocity time integral) method (group 2) at baseline. At 4 weeks, patients were crossed-over to AV optimization in group 1 and returned to nominal AV settings in group 2 for another period of 4 weeks.Oxygen uptake efficiency slope improved significantly after AV optimization (by 126.7 mL/logL ± 190.7 mL/logL; P = 0.003).Conclusions AV optimization in dual-chamber pacing significantly improved functional capacity after 4 weeks. These data provide the background for further validation studies. Keywords AV optimization -interatrial conduction delay -interatrial mechanical delay -dual-chamber pacemaker.contraction of the left atrium can compromise left ventricular filling, leading to an early increase in atrial filling pressures and a limitation in functional exercise capacity 2 . Oxygen uptake efficiency slope (OUES) is a validated marker of exercise capacity in healthy subjects and in patients with heart failure 3 .Resolution of left AV asynchrony in DDD pacing can be obtained by AV delay optimization and has been shown to improve acute haemodynamics in patients with an important IACD 4,5 . Several validated methods for AV optimization exist 6 . However, data on the effects of this intervention on short-and long-term clinical end points as exercise capacity, morbidity and mortality, are sparse.The aim of this pilot study was to investigate the short-term effect of AV optimization on functional [ Original article ]

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Section: Other Outcome Measuressupporting

confidence: 83%

Clinical benefit of atrio-ventricular delay optimization in patients with a dual-chamber pacemaker: a pilot study. The CBRAVO trial (NCT01998256)

et al. 2016

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“… [16] , [17] , [18] Pacing the interatrial septum at either upper part (Bachmann’s bundle region) or at lower part (above the coronary sinus ostium) has been advocated to achieve or maintain atrial synchrony and prevent atrial fibrillation. [19] , [20] …”

Section: Discussionmentioning

confidence: 99%

“…However, as previously suggested low RA septal pacing may be effective only in patients with intraatrial conduction delay whereas patients with interatrial conduction delay needs pacing at the upper atrial septum near the region of Bachmann’s bundle. [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] …”

Section: Discussionmentioning

confidence: 99%

Low interatrial septal pacing: A simple method

Das

Kahali²,

Dutta

2017

Indian Heart Journal

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BackgroundSinus node disease is associated with widespread structural and electrophysiological changes in the atria in addition to abnormalities at the sinus node. The atrial conduction disorder in patients with atrial pacing results in higher incidence of atrial fibrillation. Studies have shown that low interatrial septal pacing is superior to right atrial appendage pacing in preventing persistent or permanent atrial fibrillation in these patients. However, implantation of active fixation lead in low interatrial septal position is difficult and time consuming with conventional stylet, inhibiting application of this method in routine practice.MethodThe technique of implanting atrial pacing lead in low interatrial septum with hand-made stylet is presented in this study with emphasis on fluoroscopic landmark and electrocardiographic P wave pattern.ResultsThe results indicate acute and short-term success of low interatrial septal pacing in 10 patients out of 11 patients without major complications. Pacing parameters during implantation and 3 months post procedure were within normal limits.ConclusionThe initial favorable results of this study indicate low interatrial septal pacing with conventional active fixation lead using fluoroscopic landmark and electrocardiographic characteristics is feasible and reproducible with a simple technique.

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“…RAARAA pacing is employed to treat Sinus node dysfunction and suppress atrial fibrillation, but may further aggravate the atrial physiology that underlies these conditions and may worsen atrial dyssynchrony 2, 9, 10. Pacing the inter-atrial septum at either upper part (BB region) or at lower part (above the coronary sinus ostium) has been advocated to achieve or maintain atrial synchrony and prevent atrial fibrillation 11, 12. Study suggests the Bachman's bundle should be considered the preferred site for atrial pacing in patients with a history of paroxysmal atrial fibrillation 13 …”

Section: Discussionmentioning

confidence: 99%

A simple method for Bachmann's bundle pacing with indigenous modification of J-stylet

Das

Banerjee

Mandal

2016

Indian Heart Journal

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Interatrial Septum Pacing Decreases Atrial Dyssynchrony on Strain Rate Imaging Compared with Right Atrial Appendage Pacing

Abstract: IAS-P decreased the contraction delay on atrial TDI compared to RAA-P; however, it did not contribute to the reduction of AF incidence in the present study.

Cited by 8 publications

References 31 publications

Clinical benefit of atrio-ventricular delay optimization in patients with a dual-chamber pacemaker: a pilot study. The CBRAVO trial (NCT01998256)

Clinical benefit of atrio-ventricular delay optimization in patients with a dual-chamber pacemaker: a pilot study. The CBRAVO trial (NCT01998256)

Low interatrial septal pacing: A simple method

A simple method for Bachmann's bundle pacing with indigenous modification of J-stylet

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