[Preventive pacing in patients with paroxysmal atrial fibrillation: programming and follow-up of patients with dual-chamber pacemakers and triggered preventive pacing functions].

A treatment of patients with paroxysmal atrial fibrillation is the implantation of DDDRP pacemakers for preventive pacing. Atrial pacing with the aim for preventive pacing of atrial fibrillation can be classified as continuous constant pacing with a fixed manually programmed lower atrial pacing rate. The second approach is continuous dynamic overdrive pacing realized by new pacing algorithms, e.g., Pace Conditioning in the Vitatron DDDRP pacemakers. The third approach is discontinuous triggered pacing when specific pacing algorithms are activated by trigger events and temporally pace the atrium. The actual established indications for preventive pacing are patients with a conventional pacing indication and a history of paroxysmal atrial fibrillation. A possible indication are patients with a standard indication for cardiac pacing and a high risk to develop atrial fibrillation as well as patients with drug-refractory atrial fibrillation before AV-node ablation. After pacemaker implantation the pacemaker can be programmed individually according to the onsets of atrial fibrillation observed in the patient or the patient receives a standard programming and subsequently an individual adjustment of the pacing functions. The success of preventive pacing should be assessed a each follow-up visit by interrogation of the extended diagnostic pacemaker counters. There are at present no prospective studies concerning the effects of different pacemaker programming.