The Acute Effect of Cardiac Pacing Mode on Endothelial Vasodilation: Prospective, Double‐Blind, Cross‐Over, Comparative Clinical Study

Fak, Ali Serdar; Özben, Beste; Toprak, Ahmet; Çinçin, Altuğ; Papila, Nurdan; Tanrikulu, M. Azra; Oktay, Ahmet

doi:10.1111/j.1540-8159.2008.00993.x

Cited by 4 publications

(4 citation statements)

References 33 publications

(33 reference statements)

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“…An increased LA pressure is associated with arrhythmogenic remodeling (16) and mechano-electric feedback (22), which may promote recurrence of AF. In addition, as mentioned above, right ventricular pacing has recently been demonstrated to cause endothelial dysfunction (17). Endothelial dysfunction is an important predictor of recurrence of AF after catheter ablation (23).…”

Section: Discussionmentioning

confidence: 97%

“…These factors result in a decreased LV systolic function, mitral regurgitation and higher LA pressure (15), which may promote arrhythmogenic remodeling (16) and increase the incidence of AF. Furthermore, right ventricular pacing has recently been demonstrated to cause systemic endothelial dysfunction, suggesting a novel mechanism for its association with AF (17). A previous study (18) and a metaanalysis (10) reported that atrial pacing also increases the incidence of AF.…”

Section: Discussionmentioning

confidence: 99%

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Efficacy of Catheter Ablation for Atrial Fibrillation in Patients with a Permanent Pacemaker for Sick Sinus Syndrome

Dong

Sang

et al. 2013

Intern. Med.

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Objective To study the clinical efficacy of catheter ablation for paroxysmal atrial fibrillation (AF) in patients with a permanent pacemaker (PM) for sick sinus syndrome (SSS). Methods Our prospectively established database of patients who underwent circumferential pulmonary vein (PV) ablation for paroxysmal AF was retrospectively reviewed. A total of 41 patients with a permanent PM for the treatment of SSS (SSS+PM group) and 123 age-and gender-matched control subjects (on a 1: 3 basis) without SSS or a permanent PM (no-SSS+no-PM group) were included in this study. AF recurrence was defined as the occurrence of confirmed atrial tachyarrhythmia lasting more than 30 seconds beyond three months after catheter ablation in the absence of any antiarrhythmic treatment. Results During a mean follow-up period of 18.3±10.6 months (range 3-30 months), 50 patients (30.5%) developed recurrence of AF. The recurrence rate was higher in the SSS+PM group than in the no-SSS+no-PM group (43.9% vs. 26.3%, p=0.011). A Cox regression analysis adjusted for age, valvular heart disease, left atrial (LA) diameter and PV isolation identified only SSS and the use of a PM together as an independent predictor of recurrence of AF (hazard ratio 2.02, 95% confidence interval 1.10-3.69, p=0.023). Conclusion Patients with a permanent PM for SSS are at an increased risk of recurrence of AF after catheter ablation.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Efficacy of Catheter Ablation for Atrial Fibrillation in Patients with a Permanent Pacemaker for Sick Sinus Syndrome

Dong

Sang

et al. 2013

Intern. Med.

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“…Second, right ventricular pacing has recently been demonstrated to cause endothelial dysfunction. 28) Endothelial dysfunction is an important predictor of recurrence of AF after catheter ablation. 23) Third, RV lead induced TR.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Catheter Ablation for Atrial Fibrillation in Patients With a Permanent Pacemaker for Atrioventricular Block

Dong

Wang

et al. 2014

Int. Heart J.

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SummaryCatheter ablation has been established to be an effective therapy for drug-refractory paroxysmal AF and is recommended as the treatment of choice for many patients, including those with a permanent pacemaker (PM). However, the clinical efficacy of catheter ablation of paroxysmal AF in patients with a permanent PM for atrioventricular block (AVB) is not clear. Twenty-nine patients with a permanent PM for AVB (AVB + PM group), and 145 age-and gender-matched control patients (on a 1:5 basis) without AVB and without a permanent PM (no-AVB + no-PM group), were included in this study. Atrial fibrillation (AF) recurrence was defined as the occurrence of confirmed atrial tachyarrhythmia lasting more than 30 seconds beyond 3 months after catheter ablation in the absence of any antiarrhythmic treatment. During a mean follow-up period of 14.2 ± 8.6 months (range, 3-30 months), 54 patients (31.0%) developed recurrence of AF. The recurrence rate was higher in the AVB + PM group than in the no-AVB + no-PM group (48.3% versus 27.6%, P = 0.005). Cox regression analysis with adjustment for age, valvular heart disease, AVB and a PM together, left atrial (LA) diameter and PV isolation identified LA diameter (hazard ratio 1.054, 95% confidence interval 1.001-1.110, P = 0.047) and AVB and a PM together (hazard ratio 2.095, 95% confidence interval 1.109-3.960, P = 0.023) as two independent predictors of recurrence of AF. Patients with a permanent PM for AVB were at an increased risk of recurrence of AF after catheter ablation. (Int Heart J 2014; 55: 489-493) Key words: Recurrence A trial fibrillation (AF) is a common cardiac arrhythmia in the general population 1) and is associated with increased cardiovascular morbidity and mortality.2,3) A recent study showed that AF is the most frequent tachyarrhythmia in patients with a permanent pacemaker (PM), occurring in up to 37% of patients implanted due to atrioventricular block (AVB).4) Catheter ablation has been established to be an effective therapy for drug-refractory paroxysmal AF and is recommended as the treatment of choice for many patients, including those with a permanent PM. However, there is still a risk of recurrence after ablation. Our previous study evaluated the clinical efficacy of catheter ablation of paroxysmal AF in patients with a permanent PM for sick sinus syndrome (SSS) and showed that SSS and the use of a pacemaker together was an independent predictor of recurrence of AF. 5) SSS is primarily a disease of the elderly and is presumed to be due to senescence of the sinus node and atrial muscle. 6) Thus, SSS likely reflects an underlying atrial disease, which may be associated with an increased rate of recurrence of AF. In AVB patients with a permanent PM, although AVB may contribute little to the development of AF recurrence, the cumulative percentages of ventricular pacing may be higher in AVB patients than in SSS patients. Whether these patients also have an increased risk of recurrence of AF after catheter ablation is not clear. This retrospective study ...

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“…36,37 It should be noted, however, that the impact of pacing on endothelial function has been investigated both in terms of atrial-based vs. ventricular demand pacing and in the setting of biventricular pacing in patients with heart failure. Fak et al 38 showed an acute attenuation of flow mediated dilatation in 12 individuals when their pacemakers were programmed to ventricular demand pacing, as opposed to atrial-based pacing and Rubaj et al 20 demonstrated that biventricular pacing, which avoids ventricular dyssynchrony, was associated with reduced oxidative stress, NO metabolites and immune activation, and improved tissue perfusion, compared with right ventricular pacing in heart failure patients. More recently, Akar et al 39 reported that in patients with heart failure and electrical dyssynchrony as evidenced by QRS duration .120 ms, a positive response to cardiac resynchronization therapy (CRT) was more likely in patients with endothelial dysfunction before CRT.…”

Section: Discussionmentioning

confidence: 99%

Right ventricular pacing impairs endothelial function in man

Choy¹,

Su²,

Elder³

et al. 2011

Europace

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The Acute Effect of Cardiac Pacing Mode on Endothelial Vasodilation: Prospective, Double‐Blind, Cross‐Over, Comparative Clinical Study

Abstract: Acute ventricular demand pacing (VVI pacing) is clearly associated with attenuation of FMD in patients with atrial-based pacing systems. The attenuation of endothelial vasodilation might have a role in hemodynamic and clinical deterioration in patients with VVI pacemakers.

Cited by 4 publications

References 33 publications

Efficacy of Catheter Ablation for Atrial Fibrillation in Patients with a Permanent Pacemaker for Sick Sinus Syndrome

Efficacy of Catheter Ablation for Atrial Fibrillation in Patients with a Permanent Pacemaker for Sick Sinus Syndrome

Efficacy of Catheter Ablation for Atrial Fibrillation in Patients With a Permanent Pacemaker for Atrioventricular Block

Right ventricular pacing impairs endothelial function in man

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