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The effect of atrial pacing therapies on atrial tachyarrhythmia burden and frequency

Results of a randomized trial in patients with bradycardia and atrial tachyarrhythmias

Michael A. Lee, MD, FACC^*,*, Richard Weachter, MD, FACC, Scott Pollak, MD, FACC, Mark S. Kremers, MD, FACC, Ajay M. Naik, MD^||, Russell Silverman, MD, FACC^¶, Joann Tuzi, RN^**, Wayne Wang, MS^**, Linda J. Johnson, PhD^**, David E. Euler, PhD^** ATTEST Investigators

^* John Muir/Mount Diablo Medical Center, Walnut Creek, California, USA
Ferrell-Duncan Clinic and Cox Medical Center, Springfield, Missouri, USA
Florida Heart Institute and Florida Hospital, Orlando, Florida, USA
MidCarolina Cardiology and Presbyterian Hospital, Charlotte, North Carolina, USA
^|| Cedar-Sinai Medical Center and UCLA School of Medicine, Los Angeles, California, USA
^¶ St. Joseph’s Hospital Health Center, Syracuse, New York, USA
^** Medtronic Inc., Minneapolis, Minnesota, USA

View larger version (29K): [in a new window]   Figure 1 Cardiac compass report. The atrial pacing therapies were activated on January 20. The vertical dashed line indicates the last device interrogation. The atrial tachycardia (AT)/atrial fibrillation (AF) Patient Check indicates the days that the patient used his or her activator because of symptoms. The patient received the activator at the time of randomization. CV = cardioversion.

View larger version (17K): [in a new window]   Figure 2 An atrial tachycardia (AT) episode that was terminated by Ramp therapy. The graph shows the intervals between atrial (A-A) and ventricular (V-V) events at episode onset, detection, first therapy, and termination. The Ramp therapy was initiated 3.8 min after detection and resulted in the immediate termination of the atrial tachyarrhythmia. AF = atrial fibrillation.

View larger version (32K): [in a new window]   Figure 3 Histogram of atrial tachycardia/atrial fibrillation episode duration. The median episode frequency in each duration band was compared between the ON and OFF groups, and no significant differences were observed (p 0.17).