Abstract:
OBJECTIVES:An initial crossover study comparing dual- and single-site right atrial pacing was performed followed by a long-term efficacy and safety evaluation of dual-site right atrial pacing in patients with drug-refractory atrial fibrillation (AF). Also examined was the efficacy of two single-site right atrial pacing modes (high right atrium and coronary sinus ostium) and the long-term need for cardioversion, antithrombotic and antiarrhythmic drug therapies during dual-site atrial pacing. METHODS:Thirty consecutive patients with drug-refractory symptomatic AF and documented primary or drug-induced bradycardia were implanted with a dual chamber rate-responsive pacemaker and two atrial leads. Single-site atrial pacing was performed at the high right atrium or the coronary sinus ostium. Continuous atrial pacing was maintained. RESULTS:Mean arrhythmia-free intervals increased from 9+/-10 days in the control period preceding implant to 143+/-110 days (p < 0.0001) in single-site right atrial pacing and 195+/-96 days in dual-site right atrial pacing (p < 0.005 versus single-site pacing and p < 0.0001 versus control). Dual-site right atrial pacing significantly increased the proportion of patients free of AF recurrence (89%) as compared to single-site right atrial pacing (62%, p = 0.02). High right atrial pacing and coronary sinus ostial pacing had similar efficacy for AF prevention. Effective rhythm control was achieved in 86% of patients during dual right atrial pacing. Seventy-eight percent of patients at 1 year and 56% at 3 years remained free of symptomatic AF. The need for cardioversion was reduced after pacemaker implant (p < 0.05) and antithrombotic therapy was reduced (p < 0.06) without any thromboembolic event. Coronary sinus ostial lead dislodgement was not observed after discharge. CONCLUSIONS:Atrial pacing in combination with antiarrhythmic drugs eliminates or markedly reduces recurrent AF. Prevention of AF is enhanced by dual-site right atrial pacing. High right atrial and coronary sinus ostial pacing do not differ in efficacy. Dual-site right atrial pacing is safe, achieves long-term rhythm control in most patients, decreases the need for cardioversion, and antithrombotic therapy can be selectively reduced.
journal_name
J Am Coll Cardioljournal_title
Journal of the American College of Cardiologyauthors
Delfaut P,Saksena S,Prakash A,Krol RBdoi
10.1016/s0735-1097(98)00489-6subject
Has Abstractpub_date
1998-12-01 00:00:00pages
1900-8issue
7eissn
0735-1097issn
1558-3597pii
S0735-1097(98)00489-6journal_volume
32pub_type
临床试验,杂志文章abstract::Obstructive sleep apnea (OSA) is an underdiagnosed condition characterized by recurrent episodes of obstruction of the upper airway leading to sleep fragmentation and intermittent hypoxia during sleep. Obesity predisposes to OSA, and the prevalence of OSA is increasing worldwide because of the ongoing epidemic of obes...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,评审
doi:10.1016/j.jacc.2013.05.045
更新日期:2013-08-13 00:00:00
abstract:OBJECTIVE:We compared long-term health outcomes associated with beta-adrenergic blocking agents and diltiazem treatment for unstable angina. BACKGROUND:No long-term data have been published comparing these two antianginal treatments in this setting. METHODS:Eligible veterans were discharged from the Veterans Affairs ...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(98)00408-2
更新日期:1998-11-01 00:00:00
abstract:BACKGROUND:The currently recommended duration of dual antiplatelet therapy (DAPT) in drug-eluting stent (DES) recipients is 12 months to reduce the risk of late stent thrombosis, particularly in those with acute coronary syndrome (ACS). OBJECTIVES:This study hypothesized that antiplatelet treatment with DAPT for 6 mon...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.jacc.2014.11.008
更新日期:2015-03-03 00:00:00
abstract::Products of ischemic metabolism can make a major contribution to electrical instability of the heart. In particular, enhanced extracellular potassium slows conduction, thereby predisposing to reentrant circuits, especially when levels of cyclic adenosine monophosphate (AMP) increase in the early ischemic period. Other...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,评审
doi:10.1016/s0735-1097(85)80549-0
更新日期:1985-06-01 00:00:00
abstract::During a period of 18 months beginning in January 1982, a total of 65 patients were referred to the Miami Heart Institute for evaluation of either aborted out of hospital sudden death, ventricular tachycardia resistant to standard clinically directed antiarrhythmic medication programs or high grade ventricular arrhyth...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(84)80411-8
更新日期:1984-10-01 00:00:00
abstract:BACKGROUND:Bacterial growth in cultures of resected heart valves of patients with infective endocarditis (IE) is influenced by pre-operative antibiotic treatment (preop-AT). OBJECTIVES:This study sought to evaluate the time dependency of valve culture results (positive valve culture [PVC] vs. negative valve culture) o...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2020.04.075
更新日期:2020-07-07 00:00:00
abstract:BACKGROUND:Pulmonary vascular disease, pulmonary endothelial dysfunction, liver fibrosis, renal disease, and exercise intolerance are common in adults with Fontan physiology. Although the pathophysiologic mechanisms linking these phenomena have been studied, certain aspects are not well understood. OBJECTIVES:This stu...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2020.10.003
更新日期:2020-12-08 00:00:00
abstract::The authors identified individual randomized controlled trials from previous meta-analyses and additional searches, and then performed meta-analyses on cardiovascular disease outcomes and all-cause mortality. The authors assessed publications from 2012, both before and including the U.S. Preventive Service Task Force ...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,meta分析
doi:10.1016/j.jacc.2018.04.020
更新日期:2018-06-05 00:00:00
abstract::Frequency analysis with fast Fourier transform and time domain analysis after signal averaging of the electrocardiogram (ECG) have given contradictory results in patients with sustained ventricular tachycardia after myocardial infarction. Therefore, the same orthogonal ECGs were analyzed in the frequency domain (Black...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(88)90368-3
更新日期:1988-07-01 00:00:00
abstract::The purpose of this study was to investigate whether heart rate variability could be reliably assessed in patients with ventricular arrhythmias and to evaluate whether it is affected by antiarrhythmic drugs. The study was based on an analysis of 239 ambulatory electrocardiographic (ECG) recordings obtained from 67 pat...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(10)80172-x
更新日期:1991-03-01 00:00:00
abstract::Electrical catheter ablation of arrhythmogenic sites is now being used for the treatment of ventricular tachycardias. However, the extent and type of the ablation lesion in relation to energy level are controversial and not well known. In 10 beagles, single cathodal shocks of 30 (4 dogs), 80 (2 dogs) or 250 J (4 dogs)...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(86)80194-2
更新日期:1986-09-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to determine the spatial distribution of myocardial function (myofiber shortening and work) within the left ventricular (LV) wall during ventricular pacing. BACKGROUND:Asynchronous electrical activation, as induced by ventricular pacing, causes various abnormalities in LV funct...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(99)00068-6
更新日期:1999-05-01 00:00:00
abstract::Artificial intelligence (AI) is a field of computer science that aims to mimic human thought processes, learning capacity, and knowledge storage. AI techniques have been applied in cardiovascular medicine to explore novel genotypes and phenotypes in existing diseases, improve the quality of patient care, enable cost-e...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,评审
doi:10.1016/j.jacc.2017.03.571
更新日期:2017-05-30 00:00:00
abstract:OBJECTIVES:The study compared a hand-carried echocardiography (HC) device with standard echocardiography (SE) in critically ill patients. BACKGROUND:Recently, small HC devices have been introduced, and early reports showed a good correlation with SE. METHODS:We used HC (SonoSite, Bothell, Washington) echocardiography...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(01)01293-1
更新日期:2001-06-15 00:00:00
abstract:OBJECTIVES:In view of previous experimental evidence relating sympathetic nervous overactivity in the heart to myocardial necrosis and ventricular arrhythmias, we prospectively examined the hypothesis that heightened cardiac sympathetic nervous activity is associated with an adverse outcome in patients with moderate to...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(95)00332-0
更新日期:1995-11-01 00:00:00
abstract:OBJECTIVES:The goal of this study was to evaluate glycoprotein IIb/IIIa inhibition with eptifibatide when administered with indirect thrombin inhibition as compared with monotherapy with direct thrombin inhibition with bivalirudin among patients with non-ST-segment elevation acute coronary syndromes (ACS). BACKGROUND:...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jacc.2005.12.077
更新日期:2006-06-20 00:00:00
abstract:OBJECTIVES:The present study examined whether sudden death in patients with hypertrophic cardiomyopathy occurred with a particular pattern of frequency throughout the day. BACKGROUND:Previous investigators have shown a circadian distribution in the occurrence of sudden death and other cardiovascular events in patients...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(94)90384-0
更新日期:1994-05-01 00:00:00
abstract:OBJECTIVES:We sought to characterize the predictors of incident congestive heart failure (CHF), as determined by central adjudication, in a community-based elderly population. BACKGROUND:The elderly constitute a growing proportion of patients admitted to the hospital with CHF, and CHF is a leading source of morbidity ...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(00)00582-9
更新日期:2000-05-01 00:00:00
abstract:OBJECTIVES:We performed Holter monitoring on days 4 and 7 after acute myocardial infarction in 109 patients to assess whether ST segment shift would identify those with more severe coronary artery disease, left ventricular dysfunction and unfavorable prognosis. BACKGROUND:Silent myocardial ischemia is a frequent and p...
journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0735-1097(92)90242-f
更新日期:1992-11-15 00:00:00
abstract:OBJECTIVES:We compared outcomes in patients with non-ST-segment elevation acute coronary syndromes (ACS) according to the degree of cardiac troponin I (cTnI) elevation. BACKGROUND:Controlled trials of high-risk patients have found that troponin elevations identify an even higher risk subset. It is unclear whether outc...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2003.10.036
更新日期:2004-03-17 00:00:00
abstract:OBJECTIVES:This study investigated the effect of bariatric surgery (BS)-induced weight loss on cardiac ectopic fat using 3T magnetic resonance imaging in morbid obesity. BACKGROUND:Heart disease is one of the leading causes of mortality and morbidity in obese patients. Deposition of cardiac ectopic fat has been relate...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2012.06.016
更新日期:2012-10-09 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(02)02041-7
更新日期:2002-09-04 00:00:00
abstract:OBJECTIVES:We sought to determine which ion current predominantly affects defibrillation outcomes by using specific pharmacologic probes (lidocaine [a sodium channel blocking agent] and cesium [an outward potassium channel blocking agent]) in 26 swine. BACKGROUND:The effect of a drug on sodium or potassium channel con...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(96)00027-7
更新日期:1996-05-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(95)00502-1
更新日期:1996-02-01 00:00:00
abstract:BACKGROUND:The optimal systolic blood pressure (SBP) treatment goal is in question, with SPRINT (Systolic Blood Pressure Intervention Trial) suggesting benefit for 120 mm Hg. However, achieving an SBP this low may reduce diastolic blood pressure (DBP) to levels that could compromise myocardial perfusion. OBJECTIVES:Th...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2016.07.754
更新日期:2016-10-18 00:00:00
abstract::Adjusted subcutaneous heparin was used for thromboembolism prophylaxis during 18 pregnancies in 16 women with an artificial heart valve. Oral warfarin was replaced by subcutaneous heparin as soon as pregnancy was confirmed. The dosage of heparin was adjusted to maintain a partial thromboplastin time at 1.5 times the c...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(86)80116-4
更新日期:1986-07-01 00:00:00
abstract::The management of anticoagulant therapy in patients with atrial fibrillation undergoing electrical cardioversion remains controversial, largely because of inadequate studies demonstrating risk or benefit, a relatively inconvenient anticoagulation management strategy and the increasing use of transesophageal echocardio...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,评审
doi:10.1016/0735-1097(94)90443-x
更新日期:1994-02-01 00:00:00
abstract::Percutaneous balloon valvuloplasty was attempted in 10 newborn infants with critical aortic valve stenosis and severe congestive heart failure. Three had a very small left ventricle and aortic anulus. In one infant, the aortic valve could not be passed, and in another infant, a technical error resulted in severe valvu...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(89)90268-4
更新日期:1989-04-01 00:00:00
abstract:BACKGROUND:In the months after acute myocardial infarction (MI), risk for acute atherothrombotic events in nonculprit arteries increases several fold. OBJECTIVES:This study investigated whether sustained proinflammatory and prothrombotic endothelial alterations occur in remote vessels after MI. METHODS:Wild-type mice...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2018.06.044
更新日期:2018-08-28 00:00:00
abstract:OBJECTIVES:The goal of this study was to determine factors associated with receiving cardiologist care among patients with an acute exacerbation of congestive heart failure. BACKGROUND:Because cardiologist care for acute cardiovascular illness may improve care, barriers to specialty care could impact patient outcomes....
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,多中心研究
doi:10.1016/s0735-1097(00)01005-6
更新日期:2000-12-01 00:00:00