Atrial burst pacing with biphasic and monophasic waveforms for atrial fibrillation

Alon Barsheshet, Menachem Wakslak, Morton Maimon Mower, Ilan Goldenberg, Burr Hall

Research output: Contribution to journalArticle

Abstract

Background: Biphasic pacing is a novel mode of pacing that was suggested to increase cardiac conduction velocity as compared with cathodal monophasic pacing. We aimed to evaluate the safety and efficacy of rapid atrial pacing to convert atrial fibrillation (AF) to normal sinus rhythm. Methods: Multiple biphasic (anodal/cathodal), reverse biphasic (cathodal/anodal), and monophasic (cathodal) atrial pacing therapies were performed among 12 patients undergoing left atrial catheter ablation for AF. The efficacy end point was successful conversion of AF to sinus rhythm, and safety end point no induction of ventricular arrhythmias. Patients were paced at three cycle lengths (100, 200, and 333 msec) for 60 seconds at three locations (right and left atrial appendages and coronary sinus). Results: Among the 66 biphasic (anodal/cathodal) pacing procedures one procedure in a patient with chronic AF, which involved pacing at the left atrial appendage with a cycle length of 200 msec, led to conversion of AF to sinus rhythm. None of the 66 monophasic pacing procedures or the 66 reverse biphasic (cathodal/anodal) pacing procedures was associated with AF termination. None of the biphasic pacing procedures was associated with induction of ventricular arrhythmias. Conclusions: Rapid atrial pacing using a variety of waveforms at the cycle length and output used in the current study was found to be safe. There was a single success in converting a chronic AF to sinus rhythm.

Original languageEnglish (US)
Pages (from-to)22-27
Number of pages6
JournalAnnals of Noninvasive Electrocardiology
Volume17
Issue number1
DOIs
StatePublished - Jan 2012

Fingerprint

Atrial Fibrillation
Atrial Appendage
Cardiac Arrhythmias
Safety
Catheter Ablation
Coronary Sinus

Keywords

  • atrial fibrillation/atrial arrhythmias
  • basic, cellular electrophysiology/ electropharmocology

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Atrial burst pacing with biphasic and monophasic waveforms for atrial fibrillation. / Barsheshet, Alon; Wakslak, Menachem; Mower, Morton Maimon; Goldenberg, Ilan; Hall, Burr.

In: Annals of Noninvasive Electrocardiology, Vol. 17, No. 1, 01.2012, p. 22-27.

Research output: Contribution to journalArticle

Barsheshet, Alon ; Wakslak, Menachem ; Mower, Morton Maimon ; Goldenberg, Ilan ; Hall, Burr. / Atrial burst pacing with biphasic and monophasic waveforms for atrial fibrillation. In: Annals of Noninvasive Electrocardiology. 2012 ; Vol. 17, No. 1. pp. 22-27.
@article{f1e8618f141e47bbb7ec0a15b1399318,
title = "Atrial burst pacing with biphasic and monophasic waveforms for atrial fibrillation",
abstract = "Background: Biphasic pacing is a novel mode of pacing that was suggested to increase cardiac conduction velocity as compared with cathodal monophasic pacing. We aimed to evaluate the safety and efficacy of rapid atrial pacing to convert atrial fibrillation (AF) to normal sinus rhythm. Methods: Multiple biphasic (anodal/cathodal), reverse biphasic (cathodal/anodal), and monophasic (cathodal) atrial pacing therapies were performed among 12 patients undergoing left atrial catheter ablation for AF. The efficacy end point was successful conversion of AF to sinus rhythm, and safety end point no induction of ventricular arrhythmias. Patients were paced at three cycle lengths (100, 200, and 333 msec) for 60 seconds at three locations (right and left atrial appendages and coronary sinus). Results: Among the 66 biphasic (anodal/cathodal) pacing procedures one procedure in a patient with chronic AF, which involved pacing at the left atrial appendage with a cycle length of 200 msec, led to conversion of AF to sinus rhythm. None of the 66 monophasic pacing procedures or the 66 reverse biphasic (cathodal/anodal) pacing procedures was associated with AF termination. None of the biphasic pacing procedures was associated with induction of ventricular arrhythmias. Conclusions: Rapid atrial pacing using a variety of waveforms at the cycle length and output used in the current study was found to be safe. There was a single success in converting a chronic AF to sinus rhythm.",
keywords = "atrial fibrillation/atrial arrhythmias, basic, cellular electrophysiology/ electropharmocology",
author = "Alon Barsheshet and Menachem Wakslak and Mower, {Morton Maimon} and Ilan Goldenberg and Burr Hall",
year = "2012",
month = "1",
doi = "10.1111/j.1542-474X.2011.00477.x",
language = "English (US)",
volume = "17",
pages = "22--27",
journal = "Annals of Noninvasive Electrocardiology",
issn = "1082-720X",
publisher = "Wiley-Blackwell",
number = "1",

}

TY - JOUR

T1 - Atrial burst pacing with biphasic and monophasic waveforms for atrial fibrillation

AU - Barsheshet, Alon

AU - Wakslak, Menachem

AU - Mower, Morton Maimon

AU - Goldenberg, Ilan

AU - Hall, Burr

PY - 2012/1

Y1 - 2012/1

N2 - Background: Biphasic pacing is a novel mode of pacing that was suggested to increase cardiac conduction velocity as compared with cathodal monophasic pacing. We aimed to evaluate the safety and efficacy of rapid atrial pacing to convert atrial fibrillation (AF) to normal sinus rhythm. Methods: Multiple biphasic (anodal/cathodal), reverse biphasic (cathodal/anodal), and monophasic (cathodal) atrial pacing therapies were performed among 12 patients undergoing left atrial catheter ablation for AF. The efficacy end point was successful conversion of AF to sinus rhythm, and safety end point no induction of ventricular arrhythmias. Patients were paced at three cycle lengths (100, 200, and 333 msec) for 60 seconds at three locations (right and left atrial appendages and coronary sinus). Results: Among the 66 biphasic (anodal/cathodal) pacing procedures one procedure in a patient with chronic AF, which involved pacing at the left atrial appendage with a cycle length of 200 msec, led to conversion of AF to sinus rhythm. None of the 66 monophasic pacing procedures or the 66 reverse biphasic (cathodal/anodal) pacing procedures was associated with AF termination. None of the biphasic pacing procedures was associated with induction of ventricular arrhythmias. Conclusions: Rapid atrial pacing using a variety of waveforms at the cycle length and output used in the current study was found to be safe. There was a single success in converting a chronic AF to sinus rhythm.

AB - Background: Biphasic pacing is a novel mode of pacing that was suggested to increase cardiac conduction velocity as compared with cathodal monophasic pacing. We aimed to evaluate the safety and efficacy of rapid atrial pacing to convert atrial fibrillation (AF) to normal sinus rhythm. Methods: Multiple biphasic (anodal/cathodal), reverse biphasic (cathodal/anodal), and monophasic (cathodal) atrial pacing therapies were performed among 12 patients undergoing left atrial catheter ablation for AF. The efficacy end point was successful conversion of AF to sinus rhythm, and safety end point no induction of ventricular arrhythmias. Patients were paced at three cycle lengths (100, 200, and 333 msec) for 60 seconds at three locations (right and left atrial appendages and coronary sinus). Results: Among the 66 biphasic (anodal/cathodal) pacing procedures one procedure in a patient with chronic AF, which involved pacing at the left atrial appendage with a cycle length of 200 msec, led to conversion of AF to sinus rhythm. None of the 66 monophasic pacing procedures or the 66 reverse biphasic (cathodal/anodal) pacing procedures was associated with AF termination. None of the biphasic pacing procedures was associated with induction of ventricular arrhythmias. Conclusions: Rapid atrial pacing using a variety of waveforms at the cycle length and output used in the current study was found to be safe. There was a single success in converting a chronic AF to sinus rhythm.

KW - atrial fibrillation/atrial arrhythmias

KW - basic, cellular electrophysiology/ electropharmocology

UR - http://www.scopus.com/inward/record.url?scp=84856336661&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84856336661&partnerID=8YFLogxK

U2 - 10.1111/j.1542-474X.2011.00477.x

DO - 10.1111/j.1542-474X.2011.00477.x

M3 - Article

C2 - 22276625

AN - SCOPUS:84856336661

VL - 17

SP - 22

EP - 27

JO - Annals of Noninvasive Electrocardiology

JF - Annals of Noninvasive Electrocardiology

SN - 1082-720X

IS - 1

ER -