Suppression of atrial fibrillation by interatrial septum pacing

Abstract

Interatrial septum pacing seems efficient in synchronizing atrial depolarization in patients with delayed interatrial conduction, but its clinical role in preventing atrial fibrillation is still disputed. The aim of this study was to evaluate the clinical efficacy of interatrial septum pacing guided by electrophysiological testing. Thirty patients (22 male, 8 female, 70.2+/−3.4 years) were enrolled, with drug refractory paroxysmal atrial fibrillation, sinus bradycardia, prolonged P wave duration (132.5+/−8.4 ms), enlarged left atria (inner diameter 3.5+/−0.2 cm) and high atrial fibrillation burden (20+/−3%). Multipolar catheters were used for finding the most suitable site for synchronizing the atria. Then an active fixation atrial lead was positioned at this site. During the interatrial septum pacing, the P wave duration decreased significantly (from 132.5+/−8.4 to 80.0+/−8.5 ms, P<0.001) and interatrial conduction time reduced (from 101.5+/−1.1 to 17.1+/−3.9 ms, P<0.001). After three months follow-up, the atrial fibrillation burden of the patients was decreased (from 20+/−3% to 15+/−4%, P<0.05) and sinus rhythm duration increased (from 20+/−2 days to 25+/−4 days, P<0.05). The results suggest that interatrial septum pacing reduced the incidence of drug refractory paroxysmal atrial fibrillation.