RT-41
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Biatrial pacing using standard DDD pacemaker. Long term experience in 50 pts
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Andrzej Kutarski, Teresa Widomska-Czekajska, Krzysztof Oleszczak, Maciej Wójcik, Krzysztof Poleszak.
Dept of Cardiology, University Medical Academy, Lublin, Poland
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Abstract
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Biatrial (BiA) pacing stays popular therapeutic option for
pts with reentrant atrial arrhythmias. Fifty pts with atrial flutter or fibrillation received BiA pacing
system with RAA lead connected to atrial and coronary sinus (CS) lead to ventricular port of DDD
pacemaker. During examinations RAA (progr. AAI), CS (progr. VVI) and both atria (progr. DDD with
AV=15 ms) were paced; the last one was then left as permanent. Acute, subacute and chronic
sensing conditions were satisfied. T wave was never sensed and there were any problems with V
wave sensing in CS channel. Acute, subacute and chronic values of pacing threshold and energy
consumption in CS were higher than in right atrium (RAA) but global current drain during BiA pacing
remained acceptable. RAA pacing prolonged AV conduction time, P wave duration, intraatrial
conduction and total atrial activation time (TAAT). BiA pacing shorted AV conduction and normalised
values of P wave duration and TAAT. Clinical effects of BiA pacing were generally satisfied.
Excellent results (without arrhythmias) were noted in 65% and good (rare recurrence) in 17% of
pts. Main advantages of this pacing system are possibility of precious output programming
(energy saving), sensing of atria in BP configuration, maintenance of pacing in case of
dislocation/exit-block of CS lead. Its disadvantages consist impossibility of V pacing if A-V block
occur and impossibility resynchronising pacing during premature LA excitations.
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Key Words
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