Effectiveness of triple-site triggered atrial pacing for prevention of atrial fibrillation after coronary artery bypass graft surgery

Clin Cardiol. 2005 Oct;28(10):479-82. doi: 10.1002/clc.4960281007.

Abstract

Background: Recently, several temporary multisite pacing methods have been developed for prevention of postoperative atrial fibrillation (AF).

Hypothesis: In this study, we evaluated the effect of triple-site temporary triggered pacing in the AAT mode on the development of AF in patients undergoing coronary artery bypass graft (CABG) at high risk for developing postoperative AF.

Methods: A total of 70 patients undergoing CABG were randomly assigned either to pacing group (study group, n = 35 patients) or to no pacing group (control group, n = 35 patients). The external pacemaker was programmed to pace at the atrial triggered mode at a lower rate of 40 beats/min for 4 days.

Results: Atrial fibrillation, defined as lasting > 30 s, occurred in 4 patients (11.4%) in the study group and in 16 patients (45.7%) in the control group (p = 0.003). Sustained AF, defined as AF lasting > 10 min, also was observed less frequently in the study group than in the control group (11.6 vs. 37.1%, p = 0.024). Triple-site triggered atrial pacing was observed to reduce the incidence of AF by 75% and the incidence of sustained AF by 69%.

Conclusions: We believe that multiple-site temporary pacing in the triggered mode is an effective way of preventing postoperative AF. This technique may be used especially in patients at high risk of developing AF.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Atrial Fibrillation / physiopathology
  • Atrial Fibrillation / prevention & control*
  • Cardiac Pacing, Artificial*
  • Coronary Artery Bypass*
  • Coronary Artery Disease / therapy
  • Female
  • Heart Atria / pathology
  • Heart Atria / physiopathology
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Pacemaker, Artificial
  • Postoperative Complications / prevention & control*
  • Treatment Outcome