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Permanent transvenous atrial pacing.

B S Goldman, A W Chisholm, D C MacGregor

    Canadian Journal of Surgery. Journal Canadien De Chirurgie
    |March 1, 1978
    PubMed
    Summary
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    Permanent atrial pacing offers benefits for bradyarrhythmias and tachyarrhythmias. Studies show excellent electrode stability and acceptable pacing thresholds in patients receiving permanent atrial pacing via coronary sinus or right atrial appendage implantation.

    Area of Science:

    • Cardiology
    • Electrophysiology
    • Medical Devices

    Background:

    • Atrial pacing provides electrophysiologic and hemodynamic benefits for specific arrhythmias.
    • Symptomatic bradyarrhythmias with intact atrioventricular conduction and refractory tachyarrhythmias are indications for pacing.

    Purpose of the Study:

    • To evaluate the feasibility and outcomes of permanent atrial pacing in patients.
    • To assess electrode stability and pacing parameters in two different implantation sites.

    Main Methods:

    • Retrospective analysis of 29 patients undergoing permanent atrial pacing.
    • Implantation of coronary sinus electrodes (n=16) and right atrial appendage endocardial J-electrodes (n=13).
    • Evaluation of initial and chronic pacing thresholds, P-wave voltage, and electrode stability.

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    Main Results:

    • Excellent early and late electrode stability was observed in both implantation groups.
    • Acceptably low initial pacing thresholds were achieved (mean 2.0 mA for coronary sinus, 1.3 mA for atrial appendage).
    • Adequate P-wave voltage (3.4 mV) supported pacemaker sensitivity.

    Conclusions:

    • Permanent atrial pacing is achievable with good long-term electrode stability.
    • Both coronary sinus and right atrial appendage lead placements are viable options.
    • The study demonstrates the efficacy of atrial pacing in selected patient populations.