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ORLANDO, Fla., Mar 18, 2001 (United Press International via COMTEX) -- Researchers said Sunday that by using electronic pacing devices in both upper chambers of the heart, the risk of abnormal heartbeat associated with a five-fold risk of stroke can be substantially diminished.
In patients who reported bouts of atrial fibrillation -- a rapid, incoherent, abnormal heartbeat that often occurs in elderly people -- daily or several times a week, those who had pacemaker leads implanted in both upper chambers of the heart were able to avoid the potentially deadly arrhythmia about 5.8 months during a six-month period.
Dr. Sanjeev Saksena, professor of medicine at Robert Wood Johnson School of Medicine, New Brunswick, N.J., said that patients who had one atrial chamber paced in a second group of patients were free of abnormal beats 4.7 months during the 6-month test; patients in a third group were free of arrhythmia 3.3 months during the period.
However, Saksena said the dual pacing method doesn't eliminate the need for anti-arrhythmic drugs. "In the absence of medication, the pacing -- even the dual pacing of the atria -- is not effective," he said. "That is a critical observation in this trial," said Dr. Douglas Zipes, professor of medicine at the University of Indiana, Indianapolis. "Patients still have to take drugs for this treatment to be effective."
Saksena enrolled patients in the study who had a condition known as bradycardia -- an abnormally slow heartbeat. These patients were being fitted with pacemakers to speed up the beating of their left ventricle, the chamber of the heart that pushes blood through the body. In these patients who also had bouts of atrial fibrillation, the abnormal beating of the atria in the upper chambers of the heart, additional pacing wires were implanted in either one or two chambers to test the ability of doctors to re-synchronize the heartbeat.
He estimated that 350,000 to 400,000 people in the United States had conditions which could be corrected with the dual pacing device.
"This trial, for the first time, establishes a synergistic relationship between an atrial pacing technique and antiarrhtymic therapy in patients with drug-refractory atrial fibrillation," Saksena said at the annual meeting of the American College of Cardiology in Orlando, Fla. Zipes, who said that atrial fibrillation is associated with four to five times the risk of suffering a stroke, suggested that further studies could be considered that would only deal with atrial fibrillation and not the bradycardia as well.
Saksena said he chose the mixed-arrhythmia population because the subjects were going to be fitted with a pacemaker and the experiment would not require further surgery to implant a second device. In practice, the dual atria pacing in Saksena's study involving programming a pacemaker that had three pacing leads rather than one or two.
By ED SUSMAN, UPI Science News
Copyright 2001 by United Press International.
SUBJECT CODE: 07000000 13000000
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