Advanced

Reduction of atrial fibrillation burden by atrial overdrive pacing: experience with an improved algorithm to reduce early recurrences of atrial fibrillation

Puererfellner, Helmut; Urban, Lubos; de Weerd, Gerjan; Ruiter, Jaap; Brandt, Johan LU ; Havlicek, Ales; Huegl, Burkhard; Widdershoven, Jos; Kornet, Lilian and Kessels, Roger (2009) In Europace 11(1). p.62-69
Abstract
Two independent studies have revealed a potential limitation of post-mode switch overdrive pacing (PMOP), which is its delayed start. We conducted a prospective, randomized, single blind, crossover design study (the post-long pause overdrive pacing study) to test the efficacy of an improved version of PMOP (PMOPenhanced). A total of 45 patients were enrolled, of whom 41 were analysed. The median number of atrial tachycardia/atrial fibrillation (AT/AF) episodes per day (1.38 vs. 1.19), the median number of early recurrences of atrial fibrillation (ERAF) per day (0.56 vs. 0.51), and the median AT/AF burden (time per day spent in AT/AF) (2.47 vs. 2.51 h) were not significantly different during the control and active study periods. Based on... (More)
Two independent studies have revealed a potential limitation of post-mode switch overdrive pacing (PMOP), which is its delayed start. We conducted a prospective, randomized, single blind, crossover design study (the post-long pause overdrive pacing study) to test the efficacy of an improved version of PMOP (PMOPenhanced). A total of 45 patients were enrolled, of whom 41 were analysed. The median number of atrial tachycardia/atrial fibrillation (AT/AF) episodes per day (1.38 vs. 1.19), the median number of early recurrences of atrial fibrillation (ERAF) per day (0.56 vs. 0.51), and the median AT/AF burden (time per day spent in AT/AF) (2.47 vs. 2.51 h) were not significantly different during the control and active study periods. Based on the median number of episodes per week recorded 90 days prior to enrolment, the patients were stratified by the median and then split into two groups, Group A (lower 2-Quartiles) and Group B (upper 2-Quartiles). The median AT/AF burden was significantly lower in Group B during the active study period (3.71 vs. 1.71 h, P = 0.02).The median number of AT/AF episodes per day and the median number of ERAF per day in Group B showed a trend towards reduction when the algorithm was turned on (3.79 vs. 2.44 and 2.77 vs. 1.86, respectively). In contrast, in Group A we did not demonstrate any difference in AT/AF frequency, ERAF frequency, or burden. The main finding of this study is that temporary overdrive pacing at 90 bpm for 10 min starting just prior to device-classified AT/AF termination does not show a positive effect on the overall study population. However, when enabled in patients who suffer from a high percentage of ERAF, a significant reduction in the AT/AF burden could be demonstrated. Based on these findings, further prospective studies on a more targeted patient population are needed to confirm our results. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Europace
volume
11
issue
1
pages
62 - 69
publisher
Oxford University Press
external identifiers
  • wos:000261894200013
  • scopus:58149087015
ISSN
1532-2092
DOI
10.1093/europace/eun294
language
English
LU publication?
yes
id
69ac8334-13ea-438b-bbcc-06962ae8026b (old id 1313652)
date added to LUP
2009-03-06 15:26:00
date last changed
2017-01-01 04:55:11
@article{69ac8334-13ea-438b-bbcc-06962ae8026b,
  abstract     = {Two independent studies have revealed a potential limitation of post-mode switch overdrive pacing (PMOP), which is its delayed start. We conducted a prospective, randomized, single blind, crossover design study (the post-long pause overdrive pacing study) to test the efficacy of an improved version of PMOP (PMOPenhanced). A total of 45 patients were enrolled, of whom 41 were analysed. The median number of atrial tachycardia/atrial fibrillation (AT/AF) episodes per day (1.38 vs. 1.19), the median number of early recurrences of atrial fibrillation (ERAF) per day (0.56 vs. 0.51), and the median AT/AF burden (time per day spent in AT/AF) (2.47 vs. 2.51 h) were not significantly different during the control and active study periods. Based on the median number of episodes per week recorded 90 days prior to enrolment, the patients were stratified by the median and then split into two groups, Group A (lower 2-Quartiles) and Group B (upper 2-Quartiles). The median AT/AF burden was significantly lower in Group B during the active study period (3.71 vs. 1.71 h, P = 0.02).The median number of AT/AF episodes per day and the median number of ERAF per day in Group B showed a trend towards reduction when the algorithm was turned on (3.79 vs. 2.44 and 2.77 vs. 1.86, respectively). In contrast, in Group A we did not demonstrate any difference in AT/AF frequency, ERAF frequency, or burden. The main finding of this study is that temporary overdrive pacing at 90 bpm for 10 min starting just prior to device-classified AT/AF termination does not show a positive effect on the overall study population. However, when enabled in patients who suffer from a high percentage of ERAF, a significant reduction in the AT/AF burden could be demonstrated. Based on these findings, further prospective studies on a more targeted patient population are needed to confirm our results.},
  author       = {Puererfellner, Helmut and Urban, Lubos and de Weerd, Gerjan and Ruiter, Jaap and Brandt, Johan and Havlicek, Ales and Huegl, Burkhard and Widdershoven, Jos and Kornet, Lilian and Kessels, Roger},
  issn         = {1532-2092},
  language     = {eng},
  number       = {1},
  pages        = {62--69},
  publisher    = {Oxford University Press},
  series       = {Europace},
  title        = {Reduction of atrial fibrillation burden by atrial overdrive pacing: experience with an improved algorithm to reduce early recurrences of atrial fibrillation},
  url          = {http://dx.doi.org/10.1093/europace/eun294},
  volume       = {11},
  year         = {2009},
}