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[A mechanism of terminating atrial flutter using programmed atrial stimulation]
1Kardiologische Abteilung, Allgemeines Krankenhaus Celle.
Zeitschrift Fur Kardiologie
|May 1, 1990
Summary
Programmed stimulation (PS) can terminate atrial flutter (a-flut), but pacing rates influence outcomes. High pacing rates increase the risk of permanent atrial fibrillation (a-fib) following PS for a-flut.
Area of Science:
- Electrophysiology
- Cardiac Arrhythmias
Context:
- Atrial flutter (a-flut) is a common supraventricular tachycardia.
- Programmed stimulation (PS) is a therapeutic option for terminating a-flut.
- Previous studies analyzed outcomes of PS for a-flut.
Purpose:
- To analyze the outcomes of PS in terminating a-flut.
- To investigate the relationship between pacing parameters and termination success.
- To identify factors influencing the development of atrial fibrillation (a-fib) post-PS.
Summary:
- Analysis of 1168 PS procedures from 30 studies and 107 new cases confirmed that PS terminates a-flut into sinus rhythm (SR) in 45% of cases.
- SR following brief a-fib occurred in 20%, while permanent a-fib resulted in 30% of cases.
- Higher maximal pacing rates and a smaller difference between a-flut and pacing rates were associated with a higher incidence of permanent a-fib.
Impact:
- Findings suggest that pacing rate is a critical factor in PS outcomes for a-flut.
- Optimizing pacing strategies may help reduce the incidence of permanent a-fib.
- Understanding these mechanisms can inform clinical decision-making for managing atrial flutter.