gms | German Medical Science

Background: The physiological heart rate variation may reduce paroxymal atrial fibrillation(PAF). The physiologic blend sensor mode is explored to sense the body movement as well as the change of respiration. This mode is ewpected to reduce the PAF.

Purpose: The purpose of this study is to evaluate the effects of physiological atrial pacing by physiologic blend sensor pacemaker mode on the frequency of PAF.

Subjects and methods: Sixteen patients, with at least one documented atrial fibrillation episode and a conventional antibradycardia indication for pacemaker therapy, were enrolled. In these patients, 10 patients had sick sinus syndrome and 5 patients had advanced atrioventricular block. They received pacemakers in four phases (observation phase with conventional DDD mode for one month, accelerate sensor mode (AC) phase for three months, physiologic blend sensor mode (BL) phase for three months, conventional DDD mode (CV) phase for three months). In each phase, the AF burden (hours/day), the number of PACs/day, the maximum AF duration and the percentage of atrial pacing was investigated. Anti arrhythmic agents had not been changed during this study.

Result: In observation phase, there was no MACE and pacemaker trouble and, some PAF episodes was documented in 6 sick sinus syndrome patients. There were no significant differences between PAF(+) group and PAF(-) group in the patient backgrounds except for diagnosis. In PAF(+) group, the percentage of atrial pacing during BL phase was significantly higher than that during CV phase (75.5+/-7.6% vs 49.0 +/-14.3%, p<0.05). Furthermore, significant reduction of AF duration (1.5+/-2.0 vs 2.8+/-1.1 hours, p<0.05, 46.4% reduction) and reduced tendency of AF burden (6.5+/-6.1 vs 17.2+/-17.1 hours/day, p=0.06, 62.1% reduction) were observed in BL phase compared with CV phase.

Conclusion: Physiological atrial pacing with physiologic blend sensor pacemaker mode is able to reduce PAF episodes in patients with sick sinus syndrome.