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Characteristics of successful termination of atrial fibrillation by atrial antitachycardia pacing in patients with cardiac implantable electronic devices

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Abstract

Asymptomatic paroxysmal atrial fibrillation (AF) is often found in patients implanted with cardiac implantable electronic devices (CIEDs). Second-generation atrial antitachycardia pacing (A-ATP) is effective in managing AF in patients implanted with CIEDs. The purpose of this study was to evaluate the efficacy and safety of A-ATP in patients implanted with CIEDs. This was a single-center retrospective study involving 91 patients (male 46 patients, mean age 74 ± 9 years) implanted with Reactive A-ATP equipped devices (84 patients with pacemakers, 6 with ICDs, and 1 with a CRT-D). The AF burden, rate of AF termination, and details of the activation of the A-ATP were analyzed in each patient. During a mean follow-up period of 21 ± 13 months, A-ATP was activated in 45 of 91 patients (49.5%). No patients had adverse events. Although the efficacy of the A-ATP varied among the patients, the median rate of AF termination was 44%. In comparison to the A-ATP start time, “0 min” had a higher AF termination rate by the A-ATP (39.4% vs. 24.4%, P = 0.011). The rate of termination by the A-ATP was high for AF with a long cycle length and a relatively regular rhythm. A-ATP successfully terminated AF episodes in some patients implanted with CIEDs. The optimal settings of the A-ATP will be determined in future studies.

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Data availability

The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.

References

  1. Ryder KM, Benjamin EJ (1999) Epidemiology and significance of atrial fibrillation. Am J Cardiol 84(9A):131R-138R

    Article  CAS  PubMed  Google Scholar 

  2. Lin HJ, Wolf PA, Kelly-Hayes M, Beiser AS, Kase CS, Benjamin EJ, D’Agostino RB (1996) Stroke severity in atrial fibrillation. Framingham Study Stroke 27(10):1760–1764

    Article  CAS  PubMed  Google Scholar 

  3. Boriani G, Sakamoto Y, Botto G, Komura S, Pieragnoli P, Minamiguchi H, Iacopino S, Noma T, Infusino T, Takahashi Y, Facchin D, De Rosa F, Pisanò E, Meloni S, Biffi M (2021) Prevention of long-lasting atrial fibrillation through antitachycardia pacing in DDDR pacemakers. Int J Clin Pract 75(3):e13820

    Article  CAS  PubMed  Google Scholar 

  4. Oguri N, Sairaku A, Morishima N, Hayashi Y, Muraoka Y, Tomomori S, Okada T, Nakano Y (2023) Progression from paroxysmal to persistent atrial fibrillation in pacemaker patients with tachycardia-bradycardia syndrome: a multicenter study. Heart Vessels 38(9):1149–1155

    Article  PubMed  Google Scholar 

  5. Noseworthy PA, Kaufman ES, Chen LY, Chung MK, Elkind MSV, Joglar JA, Leal MA, McCabe PJ, Pokorney SD, Yao X, American Heart Association Council on Clinical Cardiology E, Arrhythmias C, Council on Arteriosclerosis T, Vascular B, Council on C, Stroke N, Stroke C (2019) Subclinical and device-detected atrial fibrillation: pondering the knowledge gap: a scientific statement from the American heart association. Circulation 140(25):e944–e963

  6. Boriani G, Tukkie R, Manolis AS, Mont L, Purerfellner H, Santini M, Inama G, Serra P, de Sousa J, Botto GL, Mangoni L, Grammatico A, Padeletti L, Investigators M (2014) Atrial antitachycardia pacing and managed ventricular pacing in bradycardia patients with paroxysmal or persistent atrial tachyarrhythmias: the MINERVA randomized multicentre international trial. Eur Heart J 35(35):2352–2362

  7. Aizawa Y, Nakai T, Ikeya Y, Kogawa R, Saito Y, Toyama K, Yumikura T, Otsuka N, Nagashima K, Okumura Y (2022) AV timing in pacemaker patients with first-degree AV block: which is preferable, intrinsic AV conduction or pacing? Heart Vessels 37(8):1411–1417

    Article  PubMed  Google Scholar 

  8. Healey JS, Connolly SJ, Gold MR, Israel CW, Van Gelder IC, Capucci A, Lau CP, Fain E, Yang S, Bailleul C, Morillo CA, Carlson M, Themeles E, Kaufman ES, Hohnloser SH, Investigators A (2012) Subclinical atrial fibrillation and the risk of stroke. N Engl J Med 366(2):120–129

  9. Boriani G, Glotzer TV, Santini M, West TM, De Melis M, Sepsi M, Gasparini M, Lewalter T, Camm JA, Singer DE (2014) Device-detected atrial fibrillation and risk for stroke: an analysis of >10,000 patients from the SOS AF project (Stroke preventiOn Strategies based on Atrial Fibrillation information from implanted devices). Eur Heart J 35(8):508–516

    Article  PubMed  Google Scholar 

  10. Lee MA, Weachter R, Pollak S, Kremers MS, Naik AM, Silverman R, Tuzi J, Wang W, Johnson LJ, Euler DE, Investigators A (2003) The effect of atrial pacing therapies on atrial tachyarrhythmia burden and frequency: results of a randomized trial in patients with bradycardia and atrial tachyarrhythmias. J Am Coll Cardiol 41(11):1926–1932

  11. Crossley GH, Padeletti L, Zweibel S, Hudnall JH, Zhang Y, Boriani G (2019) Reactive atrial-based antitachycardia pacing therapy reduces atrial tachyarrhythmias. Pacing Clin Electrophysiol 42(7):970–979

    Article  PubMed  PubMed Central  Google Scholar 

  12. Ueda N, Kamakura T, Noda T, Nakajima K, Kataoka N, Wada M, Yamagata K, Ishibashi K, Inoue Y, Miyamoto K, Nagase S, Aiba T, Izumi C, Noguchi T, Yasuda S, Kusano K (2020) Efficacy and safety of new-generation atrial antitachycardia pacing for atrial tachyarrhythmias in patients implanted with cardiac resynchronization therapy devices. J Cardiol 75(5):559–566

    Article  PubMed  Google Scholar 

  13. Sumiyoshi H, Tasaka H, Yoshida K, Yoshino M, Kadota K (2023) Combined effects of high atrial septal pacing and reactive atrial antitachycardia pacing for reducing atrial fibrillation in sick sinus syndrome. J Arrhythm 39(4):566–573

    Article  PubMed  PubMed Central  Google Scholar 

  14. Nakagomi T, Inden Y, Yanagisawa S, Suzuki N, Tsurumi N, Watanabe R, Shimojo M, Okajima T, Suga K, Shibata R, Murohara T (2022) Characteristics of successful reactive atrial-based antitachycardia pacing in patients with cardiac implantable electronic devices: history of catheter ablation of atrial fibrillation as a predictor of high treatment efficacy. J Cardiovasc Electrophysiol 33(7):1515–1528

    Article  PubMed  Google Scholar 

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Acknowledgements

We are grateful to Mr. John Martin for editing this paper.

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, Nippon Medical School Hospital, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan

    Yoshiyasu Aizawa

  2. Komura Cardiovascular Clinic, Saitama, Japan

    Satoru Komura & Emiko Kawakami

  3. Department of Cardiology, Saiseikai Kawaguchi General Hospital, Saitama, Japan

    Satoru Komura, Emiko Kawakami, Shonosuke Watanabe, Kazuki Tanaka, Hiromu Kadowaki & Atsushi Takagi

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  1. Yoshiyasu Aizawa
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  2. Satoru Komura
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  3. Emiko Kawakami
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  6. Hiromu Kadowaki
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Correspondence to Yoshiyasu Aizawa.

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Aizawa, Y., Komura, S., Kawakami, E. et al. Characteristics of successful termination of atrial fibrillation by atrial antitachycardia pacing in patients with cardiac implantable electronic devices. Heart Vessels (2024). https://doi.org/10.1007/s00380-024-02409-2

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