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Current Cardiology Reports

, 21:127 | Cite as

Programming Pacemakers to Reduce and Terminate Atrial Fibrillation

  • Margarida Pujol-López
  • Rodolfo San Antonio
  • José María Tolosana
  • Lluís MontEmail author
Invasive Electrophysiology and Pacing (EK Heist, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Invasive Electrophysiology and Pacing

Abstract

Purpose of Review

The goal of this paper is to review present knowledge regarding preventive and antitachycardia pacing algorithms, aimed to reduce atrial fibrillation (AF) burden in patients when pacing is indicated.

Recent Findings

Reactive antitachycardia pacing (ATP), the new generation of ATP, is significantly associated with a reduced risk of AF. In patients with indication for pacing and history of AF, pacemakers endowed with atrial preventive pacing and atrial ATP combined with managed ventricular pacing proved superior to standard dual-chamber pacing. Managed ventricular pacing is an algorithm that minimizes unnecessary right ventricular pacing. Progression to persistent AF is prevented by ventricular pacing minimization in patients with normal PR interval.

Summary

The synergistic effect of pacemakers that combine atrial preventive pacing with reactive ATP and with algorithms that minimize ventricular pacing can reduce AF incidence and decrease the combined endpoint of permanent AF, hospital admissions, and mortality.

Keywords

Atrial fibrillation Atrial pacing therapies Antitachycardia pacing Pacing minimization algorithms 

Abbreviations

AF

atrial fibrillation

AV

atrioventricular

AT

atrial tachycardia

ATP

antitachycardia pacing

DDDRP

dual-chamber pacemaker with atrial preventive pacing + atrial antitachycardia pacing

IRAF

immediate reinitiation of atrial fibrillation

MVP

managed ventricular pacing

PAC

premature atrial complex

Notes

Acknowledgments

The authors thank Elaine Lilly, for manuscript editing, and Neus Portella for administrative and editing support.

Compliance with Ethical Standards

Conflict of Interest

Margarida Pujol-López and Rodolfo San Antonio declare that they have no conflict of interest in relation to the content of this manuscript. Dr. JM Tolosana has received honoraria as a lecturer and consultant for Abbott, Boston Scientific and Medtronic. Dr. L. Mont has received unrestricted research grants, fellowship program support, and hononaria as a lecturer and consultant from Abbott, Biotronik, Boston Scientific, Livanova, and Medtronic.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Margarida Pujol-López
    • 1
  • Rodolfo San Antonio
    • 1
  • José María Tolosana
    • 1
    • 2
  • Lluís Mont
    • 1
    • 2
    • 3
    Email author
  1. 1.Institut Clínic Cardiovascular (ICCV), Hospital ClínicUniversitat de BarcelonaBarcelonaSpain
  2. 2.Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)BarcelonaSpain
  3. 3.Institut Clínic Cardiovascular (ICCV), Hospital ClínicUniversitat de BarcelonaBarcelonaSpain

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