Impact of consistent atrial pacing algorithm on premature atrial complexe number and paroxysmal atrial fibrillation recurrences in brady-tachy syndrome: A randomized prospective cross over study

Aim of the study: The Consistent Atrial Pacing (CAP) algorithm has been designed to achieve a high percentage of atrial pacing to suppress paroxysmal atrial fibrillation. The aim of our study was to compare the impact of DDDR+CAP versus DDDR pacing on paroxysmal atrial fibrillation recurrences and triggers in patients with Brady-Tachy Syndrome. Methods: 61 patients, 23 M and 38 F, mean age 75 +/-9 y, affected by Brady-Tachy Syndrome, implanted with a DDDR pacemaker, were randomized to DDDR or DDDR+CAP pacing with cross over of pacing modality after 1 month. Results: 78% of patients in DDDR pacing and 73% in DDDR+CAP pacing (p=n.s.) were free from symptomatic paroxysmal atrial fibrillation recurrences. During DDDR+CAP pacing, the atrial pacing percentage increased from 77 +/- 29% to 96 +/-7% (p <0.0001). Automatic mode switch episodes/day were 0.73 +/-1.09 in DDDR and 0.79 +/-1.14 (p=n.s.) in DDDR+CAP. In patients with less than 50% of atrial pacing during DDDR, automaticmode switch episodes/day decreased during DDDR+CAP from 1.13 +/-1.59 to 0.23 +/-0.32 (p <0.05) and in patients with less than 90% from 1.23 +/-1.27 to 0.75 +/-1.10 (p <0.001). The number of premature atrial complexes per day decreased during DDDR+CAP from 2665 +/- 4468 to 556 +/- 704 (p