Randomized, double-blind trial of simultaneous right and left atrial epicardial pacing for prevention of post-open heart surgery atrial fibrillation

被引:56
作者
Daoud, EG
Dabir, R
Archambeau, M
Morady, F
Strickberger, SA
机构
[1] Univ Michigan, Med Ctr, Div Cardiol, Ann Arbor, MI 48109 USA
[2] Oakwood Hosp, Div Cardiol, Ann Arbor, MI 48109 USA
[3] Oakwood Hosp, Div Cardiothorac Surg, Dearborn, MI USA
关键词
valves; bypass; surgery; arrhythmia;
D O I
10.1161/01.CIR.102.7.761
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background-The purpose of this study was to assess simultaneous right and left atrial pacing as prophylaxis for postoperative atrial fibrillation. Methods and Results-In a double-blind, randomized fashion, 118 patients who underwent open heart surgery were assigned to right atrial pacing at 45 bpm (RA-AAI; n=39), right atrial triggered pacing at a rate of greater than or equal to 85 bpm (RA-AAT; n=38), or simultaneous right and left atrial triggered pacing at a rate of greater than or equal to 85 bpm (Bi-AAT; n=41). Holter monitoring was performed for 4.8+/-1.3 days after surgery to assess for episodes of atrial fibrillation lasting >5 minutes. The prevalence of postoperative atrial fibrillation was significantly less in the patients randomized to biatrial AAT pacing when compared with the other 2 pacing regimens (P=0.02). An episode of atrial fibrillation occurred in 4 (10%) of 41 patients in the BL-AAT group compared with 11 (28%) of 39 patients in the RA-AAI group (P=0.03 versus Bi-AAT) and 13 (32%) of 38 patients in the RA-AAT group (P=0.01 versus Bi-AAT), There was no difference in the occurrence of atrial fibrillation between the right atrial AAI and AAT groups (P=0.8). There was no significant difference among the 3 groups with regard to the number of postoperative hospital days (7.3+/-9.2 days), morbidity (5.1%), or mortality rate (2.5%). Conclusions-Simultaneous right and left atrial triggered pacing is well tolerated and significantly reduces the prevalence of post-open heart surgery atrial fibrillation.
引用
收藏
页码:761 / 765
页数:5
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