ABL04: CONNECTION BETWEEN EFFICACY OF ATRIAL FIBRILLATION PREVENTIVE PACING ALGORITHMS AND ATRIAL PACING RATIO

The purpose of the study was to evaluate efficacy of main pacing algorithms for prevention of atrial fibrillation (AF) atrial pacing ratio. Methods In 17 patients (13 male, 4 female), mean age 67±6,4 years with conventional pacing indications and documented paroxysmal AF implantation of DDDRP pacemakers (11 ELA, 6 Vitatron) were performed. AF prevention algorithms were activated on 3-7th day after operation and were adopted if necessary every follow-up visit according individual mechanisms of AF onset. Each patient was programmed and evaluated at least every 3 months during 11,5±6,8 month period. We compared quantity of AF episodes/daily, AF episode duration, total AF burden (% of storage period), share of paced atrial rhythm in early (first 6 months after implantation – phase A) and late postoperational period (6-12th month after implantation – phase B). Results In 6 cases during first 3 months radiofrequency AV junction ablation was performed because persistent AF paroxysms with poor tolerability. The number of AF episodes/daily during first 3-6 months did not differ significantly between both groups (3,9 ± 5,8 vs. 2,8 ± 2,3, p=0,25) as not the atrial pacing ratio (58,6 ± 39,3% vs. 63,7 ± 25,1%, p=0,13). Average AF episode duration (171,6±99,3 min vs.105,2±74,4 min, p<0.05) and total AF burden (23,7 ± 19,0% vs. 9,2 ± 14,7%, p<0,01) significantly reduced in phase B after initial adaptation of AF-prevent algorithms. Symptomatic improvement was reported by all patients, no patient experienced pacemaker dysfunction. Conclusion AF episode duration and total AF-burden can be significantly reduced by using preventive pacing algorithms in patients with paroxysmal AF as a result of overdrive pacing. However, increase of atrial pacing ratio hardly could be a criteria of properly selected AF-prevent algorithm. Therefore, further studies to determine precise recommendations for implementation of AF-prevent algorithms needed.