Primary prevention of atrial fibrillation: does the atrial lead position influence the incidence of atrial arrhythmias in patients with sinus node dysfunction? Results from the PASTA trial...pacing of the atria in sinus node disease

Introduction: PASTA (pacing of the atria in sinus node disease) is a prospective and randomized trial, assessing the effect of different atrial lead positions on the atrial fibrillation (AF) incidence in patients with sinus node disease (SND). Method: The atrial lead position is randomized to: (a) f...

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Publicado en:Pacing & Clinical Electrophysiology Vol. 32; no. 12; pp. 1553 - 1562
Autores principales: Spitzer SG, Wacker P, Gazarek S, Malinowski K, Schibgilla V
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell Dec2009
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Dec2009
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        10.1111/j.1540-8159.2009.02544.x
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        atl: Primary prevention of atrial fibrillation: does the atrial lead position influence the incidence of atrial arrhythmias in patients with sinus node dysfunction? Results from the PASTA trial...pacing of the atria in sinus node disease
      aug:
        au:
          Spitzer SG
          Wacker P
          Gazarek S
          Malinowski K
          Schibgilla V
        affil: Praxisklinik Herz und Gefäße Dresden, Akademische Lehrpraxisklinik der TU Dresden, Dresden, Germany
      sug:
        subj:
          Arrhythmia, Atrial Etiology
          Atrial Fibrillation Prevention and Control
          Atrioventricular Node Physiology
          Electrodes, Implanted Evaluation
          Aged
          Echocardiography Methods
          Electrophysiology
          Funding Source
          Heart Atrium Anatomy and Histology
          Heart Atrium Physiopathology
          Male
          Wilcoxon Rank Sum Test
          Aged: 65+ years
          Male
      ab: Introduction: PASTA (pacing of the atria in sinus node disease) is a prospective and randomized trial, assessing the effect of different atrial lead positions on the atrial fibrillation (AF) incidence in patients with sinus node disease (SND). Method: The atrial lead position is randomized to: (a) free right atrial wall, (b) right atrial appendage (RAA), (c) coronary sinus ostium (CS-Os), or (d) dual site right atrial pacing (CS-Os + RAA). The pacemakers (Vitatron Selection 9000 or Prevent AF, Vitatron B.V., Arnhem, The Netherlands) are programmed in DDDR 70 mode and the total follow-up duration is 24 months. To describe the atrial rhythm state, pacemaker-derived data (arrhythmia counter) were assessed for AF episodes. AF was considered as evident, if the AF burden (time in AF related to follow-up interval) was >1% (i.e., 15 min/d). Follow-up data after 24 months were evaluated. Results: The analysis evaluates 142 patients (77 male, 74.5 ± 7.8 years). There was no statistical significant difference with respect to the occurrence of AF between the four groups after 24 months (A: 36%; B: 38%, C: 32%, D: 48%). The percentage of atrial/ventricular pacing was in A: 78/76%, in B: 84/81%, in C: 70/65%, and in D: 79/69%. These differences were not significant. Conclusion: The evaluation of the AF burden >1% and the total AF burden after 24 months did not show differences in the incidence of AF in patients with dual chamber pacemaker therapy for SND. We were not able to demonstrate a significant influence of right atrial lead position on the incidence of AF recurrence.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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