Abstract 18588: Clinical Impact of New-Generation Atrial Antitachycardia Pacing on Termination of Atrial Tachyarrhytmias in Patients With Bradycardia After Cardiac Surgery
Introduction: Symptomatic bradycardia and paroxysmal atrial tachyarrhythmias are sometimes clinically problematic in patients after cardiac surgery. Large clinical trial demonstrated that new-generation atrial antitachycardia pacing (Reactive ATP) was associated with reduced risk of persistent atrial fibrillation in patients with bradycardia, however, little is known about the efficacy of Reactive ATP in patients after open heart surgery.
Methods: Consecutive 23 dual-chamber pacemaker recipients with paroxysmal atrial tachyarrhythmias, who were treated by Reactive ATP (1,1041 episodes) were analyzed. Patients were divided into two groups based on their past history of cardiac surgery, Surgery group (n=7) and Non-surgery group (n=16). In Surgery group, three patients underwent valve replacement, two had simultaneous valve replacement and coronary artery bypass grafting and two underwent surgical repair of congenital heart disease. We evaluated the incidence and characteristics of successful termination episodes of atrial tachyarrhythmias.
Results: Shown the figure, there was no statistical difference between the two groups in patients’ background, though left atrial diameter was larger in Surgery group than in Non-Surgery group (51±12mm versus. 39±6mm; p=0.011). During 155±87 days follow-up, higher incidence of termination of atrial tachyarrhythmias was observed in Surgery group than in Non-surgery group (72±32% versus. 38±31%; p=0.032). Patients in Surgery group demonstrated a trend toward longer average atrial cycle length during tachyarrhythmia (235±40 msec versus. 197±39 msec; p=0.066). Progression to persistent atrial fibrillation was not observed in both groups.
Conclusions: New-generation atrial antitachycardia pacing was effective especially in patients after cardiac surgery. Surgical procedure such as atrial incision might prolong atrial cycle length, which led to successful termination of atrial tachyarrhythmias.
Author Disclosures: S. Konishi: None. H. Minamiguchi: None. O. Kentaro: None. H. Mizuno: None. T. Ohtani: None. O. Yamaguchi: None. Y. Sakata: None.
- © 2016 by American Heart Association, Inc.