Role of permanent pacing to prevent atrial fibrillation

Science Advisory from the American Heart Association Council on Clinical Cardiology (Subcommittee on Electrocardiography and Arrhythmias) and the Quality of Care and Outcomes research interdisciplinary Working Group, in collaboration with the Heart Rhythm Society

Bradley P. Knight, Bernard J. Gersh, Mark D. Carlson, Paul Andrew Friedman, Robert L. McNamara, S. Adam Strickberger, Hung Fat Tse, Albert L. Waldo

Research output: Contribution to journalArticle

71 Citations (Scopus)

Abstract

This advisory summarizes the current database on pacing modalities and algorithms used to prevent and terminate atrial fibrillation (AF). On the basis of the evidence indicating that ventricular pacing is associated with a higher incidence of AF in patients with sinus node dysfunction, a patient who has a history of AF and needs a pacemaker for bradycardia should receive a physiological pacemaker (dual chamber or atrial) rather than a single-chamber ventricular pacemaker. For patients who need a dual-chamber pacemaker, efforts should be made to program the device to minimize the amount of ventricular pacing when atrioventricular conduction is intact. Many pacemakers and implantable defibrillators have features designed to prevent AF and to terminate AF with rapid atrial pacing. The evidence to support their use is limited, although these algorithms appear to be safe and usually add little additional cost. For patients who have a bradycardia indication for pacing and also have AF, no consistent data from large randomized trials support the use of alternative single-site atrial pacing, multisite right atrial pacing, biatrial pacing, overdrive pacing, or antitachycardia atrial pacing. Even fewer data support the use of atrial pacing in the management of AF in patients without symptomatic bradycardia. At present, permanent pacing to prevent AF is not indicated; however, additional studies are ongoing, which will help to clarify the role of permanent pacing for AF.

Original languageEnglish (US)
Pages (from-to)240-243
Number of pages4
JournalCirculation
Volume111
Issue number2
DOIs
StatePublished - Jan 18 2005

Fingerprint

Quality of Health Care
Cardiology
Atrial Fibrillation
Cardiac Arrhythmias
Electrocardiography
Outcome Assessment (Health Care)
Bradycardia
Sick Sinus Syndrome
Implantable Defibrillators
Databases
Costs and Cost Analysis
Equipment and Supplies
Incidence

Keywords

  • AHA Science Advisory
  • Electrophysiology
  • Fibrillation
  • Pacemakers
  • Pacing

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

@article{bed1fdee34b0467c91abe42bbfe9cce1,
title = "Role of permanent pacing to prevent atrial fibrillation: Science Advisory from the American Heart Association Council on Clinical Cardiology (Subcommittee on Electrocardiography and Arrhythmias) and the Quality of Care and Outcomes research interdisciplinary Working Group, in collaboration with the Heart Rhythm Society",
abstract = "This advisory summarizes the current database on pacing modalities and algorithms used to prevent and terminate atrial fibrillation (AF). On the basis of the evidence indicating that ventricular pacing is associated with a higher incidence of AF in patients with sinus node dysfunction, a patient who has a history of AF and needs a pacemaker for bradycardia should receive a physiological pacemaker (dual chamber or atrial) rather than a single-chamber ventricular pacemaker. For patients who need a dual-chamber pacemaker, efforts should be made to program the device to minimize the amount of ventricular pacing when atrioventricular conduction is intact. Many pacemakers and implantable defibrillators have features designed to prevent AF and to terminate AF with rapid atrial pacing. The evidence to support their use is limited, although these algorithms appear to be safe and usually add little additional cost. For patients who have a bradycardia indication for pacing and also have AF, no consistent data from large randomized trials support the use of alternative single-site atrial pacing, multisite right atrial pacing, biatrial pacing, overdrive pacing, or antitachycardia atrial pacing. Even fewer data support the use of atrial pacing in the management of AF in patients without symptomatic bradycardia. At present, permanent pacing to prevent AF is not indicated; however, additional studies are ongoing, which will help to clarify the role of permanent pacing for AF.",
keywords = "AHA Science Advisory, Electrophysiology, Fibrillation, Pacemakers, Pacing",
author = "Knight, {Bradley P.} and Gersh, {Bernard J.} and Carlson, {Mark D.} and Friedman, {Paul Andrew} and McNamara, {Robert L.} and Strickberger, {S. Adam} and Tse, {Hung Fat} and Waldo, {Albert L.}",
year = "2005",
month = "1",
day = "18",
doi = "10.1161/01.CIR.0000151800.84945.47",
language = "English (US)",
volume = "111",
pages = "240--243",
journal = "Circulation",
issn = "0009-7322",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - Role of permanent pacing to prevent atrial fibrillation

T2 - Science Advisory from the American Heart Association Council on Clinical Cardiology (Subcommittee on Electrocardiography and Arrhythmias) and the Quality of Care and Outcomes research interdisciplinary Working Group, in collaboration with the Heart Rhythm Society

AU - Knight, Bradley P.

AU - Gersh, Bernard J.

AU - Carlson, Mark D.

AU - Friedman, Paul Andrew

AU - McNamara, Robert L.

AU - Strickberger, S. Adam

AU - Tse, Hung Fat

AU - Waldo, Albert L.

PY - 2005/1/18

Y1 - 2005/1/18

N2 - This advisory summarizes the current database on pacing modalities and algorithms used to prevent and terminate atrial fibrillation (AF). On the basis of the evidence indicating that ventricular pacing is associated with a higher incidence of AF in patients with sinus node dysfunction, a patient who has a history of AF and needs a pacemaker for bradycardia should receive a physiological pacemaker (dual chamber or atrial) rather than a single-chamber ventricular pacemaker. For patients who need a dual-chamber pacemaker, efforts should be made to program the device to minimize the amount of ventricular pacing when atrioventricular conduction is intact. Many pacemakers and implantable defibrillators have features designed to prevent AF and to terminate AF with rapid atrial pacing. The evidence to support their use is limited, although these algorithms appear to be safe and usually add little additional cost. For patients who have a bradycardia indication for pacing and also have AF, no consistent data from large randomized trials support the use of alternative single-site atrial pacing, multisite right atrial pacing, biatrial pacing, overdrive pacing, or antitachycardia atrial pacing. Even fewer data support the use of atrial pacing in the management of AF in patients without symptomatic bradycardia. At present, permanent pacing to prevent AF is not indicated; however, additional studies are ongoing, which will help to clarify the role of permanent pacing for AF.

AB - This advisory summarizes the current database on pacing modalities and algorithms used to prevent and terminate atrial fibrillation (AF). On the basis of the evidence indicating that ventricular pacing is associated with a higher incidence of AF in patients with sinus node dysfunction, a patient who has a history of AF and needs a pacemaker for bradycardia should receive a physiological pacemaker (dual chamber or atrial) rather than a single-chamber ventricular pacemaker. For patients who need a dual-chamber pacemaker, efforts should be made to program the device to minimize the amount of ventricular pacing when atrioventricular conduction is intact. Many pacemakers and implantable defibrillators have features designed to prevent AF and to terminate AF with rapid atrial pacing. The evidence to support their use is limited, although these algorithms appear to be safe and usually add little additional cost. For patients who have a bradycardia indication for pacing and also have AF, no consistent data from large randomized trials support the use of alternative single-site atrial pacing, multisite right atrial pacing, biatrial pacing, overdrive pacing, or antitachycardia atrial pacing. Even fewer data support the use of atrial pacing in the management of AF in patients without symptomatic bradycardia. At present, permanent pacing to prevent AF is not indicated; however, additional studies are ongoing, which will help to clarify the role of permanent pacing for AF.

KW - AHA Science Advisory

KW - Electrophysiology

KW - Fibrillation

KW - Pacemakers

KW - Pacing

UR - http://www.scopus.com/inward/record.url?scp=12344277382&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=12344277382&partnerID=8YFLogxK

U2 - 10.1161/01.CIR.0000151800.84945.47

DO - 10.1161/01.CIR.0000151800.84945.47

M3 - Article

VL - 111

SP - 240

EP - 243

JO - Circulation

JF - Circulation

SN - 0009-7322

IS - 2

ER -