The role of cardiac pacing in atrial arrhythmia prevention

Abstract

Pathophysiological considerations, animal data and acute clinical tests suggest some benefit of cardiac pacing in the prevention of paroxysmal atrial tachyarrhythmia. While early clinical studies confirm this notion, data of randomized prospective trials at least are mixed. The equivocal effects of using alternative atrial pacing sites and/or dedicated preventive pacing algorithms leaves the question of how to predict the beneficial effect of antitachycardia pacing strategies in the individual patient. Since the answer is lacking, the mere intention to prevent atrial arrhythmias is not a valid pacing indication. Pacing for the bradycardia tachycardia syndrome, however, may benefit from preventive techniques in individual cases.