Novel Pacing Algorithms Applied in Hybrid Therapies of Atrial Fibrillation: The Ultimate Solution?

摘要

The Latin word "hybrida" describes a "mixture" or "two origins". In the treatment of atrial fibrillation (AF), the term "hybrid therapies" is used for various "mixed" therapeutic approaches, as for example pharmacologic and ablative hybrid therapy [1] and linear lesions or preventive pacing in combination with drug therapy to maintain sinus rhythm. Apart from sophisticated pacing algorithms, pacemaker therapy to prevent AF also offers elaborate AF diagnostic capabilities. In the following, we describe a case which illustrates the use of these advanced pacemaker diagnostics to guide catheter ablation therapy of class IC drug-induced atrial flutter in a patient with initially paroxysmal AF. We also introduce the VIP registry, because it is expected that more than 50% of these patients with recurrent AF and preventive pacing receive concomitant antiarrhythmic drug therapy. The VIP registry intends to enroll 350-400 pacemaker patients and therefore might offer an opportunity to analyze the impact of specific drugs on the efficacy of different preventive pacing algorithms.