13th International Congress
THE "NEW FRONTIERS"
OF ARRHYTHMIAS 1998

January 24-31, 1998
Marilleva, Trento, Italy

RT-121

Interatrial septum pacing: an echocardiographic evaluation

Giuseppe Barletta, Maria Cristina Porciani, Riccarda Del Bene, Antonio Michelucci, Andrea Colella, Luigi Padeletti.
Istituto di Clinica Medica e Cardiologia, University of Florence, Italy

Introduction

It is agreed that dual-pacing, usually accomplished by right atrial appendage stimulation, offers several advantages over other pacing strategies¹, especially when atrioventricular delay is optimized under hemodynamic^2,3 or Doppler guidance^4-6. The electrical activity at the level of the Koch triangle and of the coronary sinus ostium have received recent attention as to the genesis and maintenance of atrial fibrillation^7,8. Pacing at the coronary sinus level has been suggested to be beneficial in preventing atrial fibrillation⁹, while permanent interatrial septal stimulation at the level of the triangle of Koch is currently under study in our laboratory. Although this was reported as long ago as 1986¹⁰ as a rescue site for permanent atrial pacing, no data are available on how interatrial septal pacing could influence the chronology of right and left atria contraction and the hemodynamic performance. In this study we will describe the timing of atrial systole and right and left ventricular filling of DDD or VDD pacing in patients with normal ventricular function who were selected among a larger series of patients in whom atrial pacing was performed by interatrial septum stimulation.