Abstract
Purpose of study Follow-up dynamic of dual chamber pacing with auto switch mode (ASM) function after atrioventricular (AV) junction ablation in patients with paroxysmal atrial fibrillation (AF) was evaluated. Methods In 65 patients (42 male, 23 female), mean age 66±7,9 years with paroxysmal AF radiofrequency (RF) ablation of AV junction with implantation of DDDR pacemaker with ASM function were performed. Each patient was evaluated every 3 months during a 15,3±2,3 month period. We analysed the quantity of mode switching events and their duration, maximal atrial rate during paroxysm and proportion of atrial sensing-ventricular pacing (As-Vp), atrial-ventricular pacing (Ap-Vp) and VVI pacing (Vp). The atrial statistic of pacemaker was the point of special assessment. Results According the results of atrial statistic sensing of AF paroxysms was adequate. In the first 3 months of after operation pacemaker detection of high atrial rate was checked by external Holter monitor. The number of paroxysmal AF episodes recorded during first 3 months were 59±17,2 and during the last – 41,2±11,2 (p=0,01); the decrease of duration in mode switching was from 192,5±51,1 min to 98,5±41,2 min (p<0.05); the duration of each AMS event shortened significantly – from 7,8±3,1 min to 1,9±1,3 min (p=0,02). The proportion of As-Vp was similar (p=NS) in both pacing modes. Symptomatic improvement was reported by all patients, while hospital visits were for ordinary pacemaker follow-up. No patient experienced pacemaker dysfunction in terms of sensing and pacing threshold. Conclusion AV junction ablation with permanent DDDR pacing with ASM is a reliable method of arrhythmia control and improvement of quality of life. It seems that atrial pacing may be a stabilising factor in patients with paroxysmal AF even if they have intact sinus node function. Results of atrial statistic of pacemaker should be implemented for analysis and correction of pacemaker program in patients with AF.
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