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Devices for Prevention of Atrial Tachyarrhythmias

Indian Pacing and Electrophysiology Journal
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  • Reviews
  • Biology
  • Computer Science
  • Pharmacology


Indian Pacing and Electrophysiology Journal - Lozano 50 Review Article Devices for Prevention of Atrial Tachyarrhythmias Ignacio Fernández Lozano, Jorge Toquero, José Antonio Fernández Díaz, Bogdan Ionescu, Vanesa Moñivas, Pilar Ortiz, Beatriz Fuertes, Luis Alonso Pulpón. Clínica Puerta de Hierro, Madrid. Address for correspondence: Ignacio Fernández Lozano, C/ Julio Palacios 20. 1º D., Madrid 28029. Email: [email protected] Introduction Atrial fibrillation (AF) is the most frequent sustained cardiac arrhythmia in clinical practice and, although its importance has been underestimated even in recent years, we are now becoming aware of its clinical transcendence1,2,3. The classical treatment is pharmacological, but its efficacy is limited and it does have side effects4,5. Therefore, in recent years, there has been an increasing interest in other types of non-pharmacological treatments6,7. Physiologic cardiac pacing has proven to be more effective than VVI mode pacing to prevent the occurrence of AF during the follow-up of patients who have had a permanent pacemaker implanted 8,9,10. There are currently different lines of research that use different atrial pacing techniques to prevent and treat episodes of paroxysmal atrial fibrillation11,12. Techniques of multi-site pacing in the right atrium or both atria, new atrial pacing sites, prevention algorithms for paroxysmal atrial fibrillation episodes, and even high-frequency atrial tachyarrhythmia termination algorithms have all been proposed. In this article, we will try to synthesize the grounds for and findings of the different lines of research currently being developed. Pacing Activation Mechanisms The occurrence of atrial fibrillation in a patient depends on the interaction of three factors: substratum, triggers and modulating factors. The substratum is the usually sick atrial myoca

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