| Objective: To assess the impact of dedicated multiform physiological atrial-based preventive pacing algorithms in the treatment of paroxysmal atrial fibrillation (PAF) and discuss the possible underlying mechanisms. Methods: 15 drug - refractory patients were implanted Vitatron Selection 900E(AF2. 0) double-chamber pacemaker, the methods of implantation is as same as the general double-chamber pacemakers . Survey PAF episodes two months before implantation and the first two months and the next two months after implantation and compare the variety of antiarrhythmic drugs. Results: Except for one patient, the numbers of symptomatic PAF episodes of other patients were significantly decrease in the first two months and the next months compared with that of two months before implantation (34. 2±18. 01, 19. 73 ± 7. 79 vs 66.30 ±26.06) ;the numbers of symptomatic PAF episodes were also significantly decreased (19.73 ± 7.79 vs 34.2 ± 18.01) ;the numbers of symptomatic PAF episodes stored (501. 73 ±368. 78 vs 872. 60 ±536. 52), total duration(8. 13 ± 5. 17d vs 16. 00 ± 7. 61d), AF burden (5. 00~20. 00% vs 15. 00—38. 33% T105) decreased in the second two months after implantation compared with that ofthe first two months after implantation(P all <0.05), but atrial pacing rate (56. 00~75. 00% vs 60. 00~80. 00% 735) was not decreased (P>0. 05). The categories of drugs decreased from 2.7 to 1.4 and the dosages also dropped in the six patients who intermittently received antiarrhythmic drugs therapy. Conclusions: Dedicated physiological atrial-based preventive pacing algorithms can decrease occurrence of PAF episodes and AF burden, and markedly increase the quality of life as well as reduce symptoms, it can also decrease the categories and dosages of antiarrhythmic drugs. Using the combination of drugs and atrial pacing may become an important technique to control PAF. |
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