Publication: Prospective randomized study to assess the efficacy of site and rate of atrial pacing on long-term progression of atrial fibrillation in sick sinus syndrome septal pacing for atrial fibrillation suppression evaluation (SAFE) study
Issued Date
2013-08-13
Resource Type
ISSN
15244539
00097322
00097322
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2-s2.0-84882271325
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Mahidol University
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SCOPUS
Bibliographic Citation
Circulation. Vol.128, No.7 (2013), 687-693
Suggested Citation
Chu Pak Lau, Ngarmukos Tachapong, Chun Chieh Wang, Jing Feng Wang, Haruhiko Abe, Chi Woon Kong, Reginald Liew, Dong Gu Shin, Luigi Padeletti, You Ho Kim, Razali Omar, Kreingkrai Jirarojanakorn, Yoon Nyun Kim, Mien Cheng Chen, Charn Sriratanasathavorn, Muhammad Munawar, Ruth Kam, Jan Yow Chen, Yong Keun Cho, Yi Gang Li, Shu Lin Wu, Christophe Bailleul, Hung Fat Tse Prospective randomized study to assess the efficacy of site and rate of atrial pacing on long-term progression of atrial fibrillation in sick sinus syndrome septal pacing for atrial fibrillation suppression evaluation (SAFE) study. Circulation. Vol.128, No.7 (2013), 687-693. doi:10.1161/CIRCULATIONAHA.113.001644 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/32210
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Title
Prospective randomized study to assess the efficacy of site and rate of atrial pacing on long-term progression of atrial fibrillation in sick sinus syndrome septal pacing for atrial fibrillation suppression evaluation (SAFE) study
Author(s)
Chu Pak Lau
Ngarmukos Tachapong
Chun Chieh Wang
Jing Feng Wang
Haruhiko Abe
Chi Woon Kong
Reginald Liew
Dong Gu Shin
Luigi Padeletti
You Ho Kim
Razali Omar
Kreingkrai Jirarojanakorn
Yoon Nyun Kim
Mien Cheng Chen
Charn Sriratanasathavorn
Muhammad Munawar
Ruth Kam
Jan Yow Chen
Yong Keun Cho
Yi Gang Li
Shu Lin Wu
Christophe Bailleul
Hung Fat Tse
Ngarmukos Tachapong
Chun Chieh Wang
Jing Feng Wang
Haruhiko Abe
Chi Woon Kong
Reginald Liew
Dong Gu Shin
Luigi Padeletti
You Ho Kim
Razali Omar
Kreingkrai Jirarojanakorn
Yoon Nyun Kim
Mien Cheng Chen
Charn Sriratanasathavorn
Muhammad Munawar
Ruth Kam
Jan Yow Chen
Yong Keun Cho
Yi Gang Li
Shu Lin Wu
Christophe Bailleul
Hung Fat Tse
Other Contributor(s)
The University of Hong Kong
Mahidol University
Chang Gung Memorial Hospital
Sun Yat-Sen University
University of Occupational and Environmental Health
Veterans General Hospital-Taipei
National Heart Centre, Singapore
Yeungnam University Medical Center
Universita degli Studi di Firenze
Asan Medical Center
Institut Jantung Negara Kuala Lumpur
Bhumibol Adulyadej Hospital
Keimyung University, Dongsan Medical Center
Chang Gung University
Harapan Kita Hospital
Changi General Hospital
China Medical University Taichung
Kyungpook National University Hospital
Shanghai Jiao Tong University
Guangdong General Hospital
St. Jude Medical
Mahidol University
Chang Gung Memorial Hospital
Sun Yat-Sen University
University of Occupational and Environmental Health
Veterans General Hospital-Taipei
National Heart Centre, Singapore
Yeungnam University Medical Center
Universita degli Studi di Firenze
Asan Medical Center
Institut Jantung Negara Kuala Lumpur
Bhumibol Adulyadej Hospital
Keimyung University, Dongsan Medical Center
Chang Gung University
Harapan Kita Hospital
Changi General Hospital
China Medical University Taichung
Kyungpook National University Hospital
Shanghai Jiao Tong University
Guangdong General Hospital
St. Jude Medical
Abstract
Background-Atrial-based pacing is associated with lower risk of atrial fibrillation (AF) in sick sinus syndrome compared with ventricular pacing; nevertheless, the impact of site and rate of atrial pacing on progression of AF remains unclear. We evaluated whether long-term atrial pacing at the right atrial (RA) appendage versus the low RA septum with (ON) or without (OFF) a continuous atrial overdrive pacing algorithm can prevent the development of persistent AF. Methods and Results-We randomized 385 patients with paroxysmal AF and sick sinus syndrome in whom a pacemaker was indicated to pacing at RA appendage ON (n=98), RA appendage OFF (n=99), RA septum ON (n=92), or RA septum OFF (n=96). The primary outcome was the occurrence of persistent AF (AF documented at least 7 days apart or need for cardioversion). Demographic data were homogeneous across both pacing site (RA appendage/RA septum) and atrial overdrive pacing (ON/OFF). After a mean follow-up of 3.1 years, persistent AF occurred in 99 patients (25.8%; annual rate of persistent AF, 8.3%). Alternative site pacing at the RA septum versus conventional RA appendage (hazard ratio=1.18; 95% confidence interval, 0.79-1.75; P=0.65) or continuous atrial overdrive pacing ON versus OFF (hazard ratio=1.17; 95% confidence interval, 0.79-1.74; P=0.69) did not prevent the development of persistent AF. Conclusions-In patients with paroxysmal AF and sick sinus syndrome requiring pacemaker implantation, an alternative atrial pacing site at the RA septum or continuous atrial overdrive pacing did not prevent the development of persistent AF. Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT00419640. © 2013 American Heart Association, Inc.