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Survival of DDD pacing mode after atrioventricular junction ablation and pacing for refractory atrial fibrillation.

Abstract：

BACKGROUND:Patients with recurrent forms of atrial fibrillation may receive dual-chamber pacemakers after atrioventricular junction ablation for refractory symptoms. These patients are at risk for chronic atrial fibrillation, which would negate the benefits of dual-chamber pacing. The purpose of this study was to examine the survival of dual-chamber pacing modes in patients undergoing ablate and pace therapy. METHODS AND RESULTS:One hundred fifty-six patients underwent ablate and pace therapy for medically refractory chronic (70 patients) or recurrent (86 patients) atrial fibrillation. Seventy-eight percent of patients had structural heart disease. The mean age was 66 +/- 11 years, with an average ejection fraction of 48% +/- 18%. The choice of pacing mode and programming were at the discretion of the investigators. At implantation, 91 patients (58%) were programmed to VVI mode, 47 (30%) were programmed to DDD mode, and 18 (12%) were programmed to DDI mode. After 1 year of follow-up, 10 DDD patients were reprogrammed to VVI mode (7 patients) or DDI mode (3 patients), most frequently for chronic atrial fibrillation (7 patients). Two patients with DDI mode were reprogrammed to VVI and DDD modes (1 patient each). Survival of the DDD mode was 76% at 1 year by Kaplan-Meier analysis. Reprogramming from DDD mode was not associated with patient age, left ventricular ejection fraction, discontinuation of antiarrhythmic drugs, or the duration of atrial fibrillation symptoms before ablation. CONCLUSIONS:Seventy-six percent of patients with recurrent atrial fibrillation who are initially programmed to DDD mode remain in DDD mode 1 year after ablation and pacing therapy. The modest rate of progression to chronic atrial fibrillation supports the use of dual-chamber pacing in this setting.

journal_name

Am Heart J

journal_title

American heart journal

authors

Wood MA,Curtis AB,Takle-Newhouse TA,Ellenbogen KA

doi

10.1016/s0002-8703(99)70223-1

subject

Has Abstract

pub_date

1999-04-01 00:00:00

pages

682-5

issue

4 Pt 1

eissn

0002-8703

issn

1097-6744

pii

S0002870399002008

journal_volume

137

pub_type

杂志文章,多中心研究

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