Biatrial pacing

Daubert C, Gras D, Berger D, Leclercq C. Permanent atrial resynchronization by synchronous biatrial pacing in the preventive treatment of atrial flutter associated with high degree of intraatrial block. Arch Mai Coeur Vaiss 1994 87 1535. 

Levy T, Walker S, Rochelle 1, Ball V. Evaluation of biatrial pacing, right atrial pacing, and no pacing in patients with drug-refractory atrial fibrillation. Am 1 Cardiol 1999 84 426. 

Several trials of biatrial pacing for prevention of AF have been undertaken in a small number of patients (total 149 subjects) with paroxysmal or persistent AF (39-43). D AUonnes treated 86 patients with persistent AF in a prospective noncontroUed study (43). They reported that 55 patients (64%) r ained in sinus rhythm, including 28 patients (33%) without documented recurrence of AF over a mean of 33 months. The greatest benefit was observed... 

Fig. 12.3 Impact of atrial pacing following cardiac surgery on atrial fibrillation (AF). Biatrial pacing was more effective at preventing AF compared to left atrial pacing or right atrial pacing. Data from Crystal E, CoimoUy SJ, Sleik K et al. Circulation 2002 106 75-80.

Mirza I, James S, Holt P. Biatrial pacing for paroxysmal atrial fibrillation. J Am... 

Fragakis N, Shakespeare CF, Lloyd G, et al. Reversion and maintenance of sinus rhythm in patients with permanent atrial fibrillation by internal cardioversion followed by biatrial pacing. Pacing Clin Electrophysiol 2002 25 278-86. 

Bimie D, Connors SP, Veinot JP, et al. Left atrial vein pacing a technique of biatrial pacing for the prevention of atrial pacing. Pacing Clin Electrophysiol 2004 27 240-5. 

GiUigan DM, Fuller lA, Clemo HF, et al. The acute effects of biatrial pacing on atrial depolarization and repolarization. Pacing Clin Electrophysiol 2000 23 1113-20. 

Levy T, Eotopoulos G, Walker S, et al. Randomized, controlled study investigating the effect of biatrial pacing in prevention of atrial fibrillation after coronary artery bypass surgery. Circulation 2000 102 1382-7. 

Kurz DJ, Naegeli B, Kunz M, et al. Epicardial, biatrial synchronous pacing for prevention of atrial fibrillation after cardiac surgery. PACE 1999 22 721-726. 

D AUones GR, Pavin D, Leclerq C, et al. Long-term effects of biatrial synchronous pacing to prevent drug-refractory atrial tachycarrhythmia a nine-year experience. J Cardiovasc Electrophysiol 2000 11 1081-91. 

Naito S, Tada H, Kaneko T, et al. Biatrial epicardial pacing prevents atrial fibrillation and confers hemodynamic benefits after coronary artery bypass surgery. Pacing Clin Electrophysiol 2005 28 S146-S149. 

Doi A, Takagi M, Toda 1, et al. Acute haemodynamic benefits of biatrial atrioventricular sequential pacing comparison with single atrial atrioventricular sequential pacing. Heart 2004 90 411 1. 

Debrunner M, Naegeh B, Genoni M, et al. Prevention of atrial fibrillation after cardiac valvular surgery by epicardial, biatrial synchronous pacing. Eur J Cardio-thoracic Surg 2004 25 16-20. 

The incidence of permanent pacemaker implantation varies between 6% and 23% (Melton et al. 1999) using the biatrial technique. If necessary a rate-responsive pacing system should be implanted as chronotropic incompetence is the rule. With the use of the bicaval anastomosis technique, the incidence of permanent pacemaker implantation diminished to less than 5%. 

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