COMPARISON OF PROGRESSION TO CHRONIC ATRIAL FIBRILLATION BETWEEN ATRIAL PACING AND DUAL-CHAMBER PACING IN RUBENSTEIN III TYPE SICK-SINUS SYNDROME : A RETROSPECTIVE STUDY

We performed a retrospective study to compare atrial pacing and dual-chamber pacing in Rubenstein III sick-sinus syndrome and to determine which mode of pacing has a higher risk of progression from paroxysmol atrial fibrilation(AF)to chronic AF(CAF).The subjects were 113 patients with Rubenstein III sick-sinus syndrome,63 treated wth atrial pacing and 50 treated with dual-chamber pacing,aged 42 to 93 years(mean age,70.2 years),with a folow-up time of 1 to 20 years(mean,8.4 years).The incidence of AF was higher with dual-chamber pacing(40%)than with atrial pacing(9.5%).The mean period before AF fixation did not differ significantly between atrial pacing(6.2 years;range,2 to 13 years)and dual-chamber pacing(6.3 years;range,2 to 15 years).The incidence of heart failure and of cerebrovascular accident and the mortality rate were higher with dual-chamber pacing(22.0%,24.0%,and 26.0%,respectively)than with atrial pacing(7.9%,9.5%,and 12.7%,respectively).Because the presence of cardiac ventricular pacing is the only difference between the pacemakers,it might be associated with progression to CAF. (Tokyo Jikeikai Medical Journal 2006;121:63-7)