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  4. Atrial septal pacing for the termination of atrial fibrillation: study in a biophysical model of human atria
 
research article

Atrial septal pacing for the termination of atrial fibrillation: study in a biophysical model of human atria

Uldry, Laurent  
•
Virag, Nathalie
•
Lindemans, Fred
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2012
Europace

Aims While successful termination by pacing of organized atrial tachycardias has been observed in patients, single site rapid pacing has not yet led to conclusive results for the termination of atrial fibrillation (AF). The purpose of this study was to evaluate a novel atrial septal pacing algorithm for the termination of AF in a biophysical model of the human atria. Methods and results Sustained AF was generated in a model based on human magnetic resonance images and membrane kinetics. Rapid pacing was applied from the septal area following a dual-stage scheme: (i) rapid pacing for 10-30 s at pacing intervals 62-70% of AF cycle length (AFCL), (ii) slow pacing for 1.5 s at 180% AFCL, initiated by a single stimulus at 130% AFCL. Atrial fibrillation termination success rates were computed. A mean success rate for AF termination of 10.2% was obtained for rapid septal pacing only. The addition of the slow pacing phase increased this rate to 20.2%. At an optimal pacing cycle length (64% AFCL) up to 29% of AF termination was observed. Conclusion The proposed septal pacing algorithm could suppress AF reentries in a more robust way than classical single site rapid pacing. Experimental studies are now needed to determine whether similar termination mechanisms and rates can be observed in animals or humans, and in which types of AF this pacing strategy might be most effective.

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Type
research article
DOI
10.1093/europace/eus279
Web of Science ID

WOS:000310636800016

Author(s)
Uldry, Laurent  
Virag, Nathalie
Lindemans, Fred
Vesin, Jean-Marc  
Kappenberger, Lukas
Date Issued

2012

Publisher

Oxford Univ Press

Published in
Europace
Volume

14

Start page

V112

End page

V120

Subjects

Atrial fibrillation

•

Septal pacing

•

Computer modelling

•

Pacemakers

Editorial or Peer reviewed

REVIEWED

Written at

EPFL

EPFL units
SCI-STI-JMV  
Available on Infoscience
February 27, 2013
Use this identifier to reference this record
https://infoscience.epfl.ch/handle/20.500.14299/89302
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