Dual chamber pacemaker in the treatment of paroxysmal atrial fibrillation

Goran Radjen, Sasa Rafajlovski, Zoran Perisic, Radoslav Romanovic
2005 Vojnosanitetski Pregled  
Uvod. Atrijumska fibrilacija predstavlja najþešüi oblik poremeüaja srþanog ritma. Cilj rada ʁɟ biɨ da se prikaže uloga i efikasnost dvokomorskog pacemakera sa algoritmom dinamskog atrijumskog preticanja u leþenju paroksizmalne atrijumske fibrilacije. Prikaz bolesnika. Bolesnici sa klasiþnim bradikardija -tahikardija sindromom i þestim napadima atrijumske fibrilacije implantiran je trajni jednokomorski pacemaker tipa VVI. Epizode simptomatske bradikardije bile su uspešno leþene VVI
more » ... cijom, ali je bolesnica i dalje imala uþestale napade atrijumske fibrilacije uprkos primene raznih antiaritmijskih lekova koje je teško podnosila. Odluþili smo da joj reimplantiramo trajni pacemaker tipa DDDR sa algoritmom dinamskog atrijumskog preticanja. Pacemaker je programiran na osnovnu frekvenciju od 75/min, uz frekvenciju u miru od 55/min, a bolesnici je dat sotalol. Nakon tri meseca simptomi su praktiþno nestali, imala je svega 4 epizode kratkotrajne atrijumske fibrilacije, uz visok nivo atrijumskog pacinga (99%). Zakljuþak. Kod odabranih bolesnika sa bradikardija -tahikardija sindromom pacing baziran na atrijumu izgleda da je veoma efikasan u smanjenju incidencije paroksizmalne atrijumske fibrilacije. K lj u þ n e r e þ i : fibrilacija pretkomora; srce, veštaþko usklaÿivanje ritma; elektrostimulator srca; bradikardija; tahikardija. DUAL CHAMBER PACEMAKER IN THE TREATMENT OF PAROXYSMAL ATRIAL FIBRILLATION Background. Atrial fibrillation is the most frequent cardiac dysrhythmia. The aim of this study was to show the role and the efficacy of a dual chamber pacemaker with the algorithm of atrial dynamic overdrive, in the suppression of paroxysmal atrial fibrillation. Case report. A woman with a classical bradycardia-tachycardia syndrome, and frequent attacks of atrial fibrillation, underwent the implantation of a single chamber permanent pacemaker (VVI). Pacemaker successfully treated the episodes of symptomatic bradycardia, but the patient had frequent attacks of atrial fibrillation, despite the use of different antiarrhythmic drugs, which she did not tolerate well. The decision was made to reimplant a permanent dual chamber pacemaker with the algorithm of atrial dynamic overdrive.The pacemaker was pro-ɋɬɪɚɧɚ 334 ȼɈȳɇɈɋȺɇɂɌȿɌɋɄɂ ɉɊȿȽɅȿȾ Ȼɪɨʁ 4 grammed to the basic rate of 75/min, while rate at rest was 55/min. In addition, sotalol was administered. After three months, the patient became asymptomatic with only 4 short í term episodes of atrial fibrillation, and a high level of atrial pacing (99%). Conclusion. In selected patients with bradycardiaítachycardia syndrome, atrial-based pacing seemed to be very effective in reducing the incidence of paroxysmal atrial fibrillation. K e y w o r d s : atrial fibrillation; cardiac pacing, artificial; pacemaker, artificial; bradycardia; tachycardia. Correspondence to: Goran Raÿen, Vojnomedicinska akademija, Klinika za kardiologiju; Crnotravska 17, 11040 Beograd, Srbija i Crna Gora. Tel: 381 11 2661 122/31 908; 2756 441.
doi:10.2298/vsp0504329r pmid:15889600 fatcat:lzizuiqrjrhpndv2ioawrxpwn4