Giuseppe Boriani, Mauro Biffi, Luigi Padeletti*, Andrea Spampinato**, Gian Luca Botto***, Carlo Pignalberi****, Andrea Grammatico°, Micol Piana°, Sergio Cavaglia°, Francesco De Seta°, Angelo Branzi.
*Clinica Medica, University of Firenze, **Villa Tiberia, Roma, ***S. Anna Hospital, Como. ****Universita Campus Biomedico Roma, °Medtronic Italia, Italy
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In patients with sick sinus syndrome with an high risk
of AF (brady-tachy syndrome), DDDR pacing is able to achieve a reduction of AF episodes both in
comparison to baseline and to DDD pacing.
The possible ways to positively influence the risk of atrial fibrillation (AF) involve pacing modality
(dual chamber or AAI vs VVI), pacing rate and extent of atrial overdrive, pacing site and, more
recently, use of dedicated pacing algorithms aimed to achieve a high percentage of atrial stimulation.
The electrophysiological background for using atrial pacing to prevent AF implies the prevention
of bradycardia-related AF episodes, the reduction of atrial premature complexes, the prevention
of short-long atrial cycles, the reduction in dispersion of conduction and refractoriness and the
reduction in stretch-induced atrial arrhythmias.
Consistent Atrial Pacing (CAP) and Atrial Rate Stabilisation (ARS) are two new pacing algorithms
for preventing recurrent paroxysmal AF.
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