{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T12:04:09Z","timestamp":1792757049756,"version":"4.5.0"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Arrhythmia and Electrophysiology"],"published-print":{"date-parts":[[2011,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background\u2014<\/jats:title>\n                    <jats:p>The role of pacing sites and atrial electrophysiology on the progression of atrial fibrillation (AF) to the permanent form in patients with sinus node dysfunction (SND) has never been investigated. The aim of the study was to investigate the relationship between atrial electrophysiology and the efficacy of atrial pacing at the low interatrial septum (IAS) or at the right atrial appendage (RAA) to prevent persistent\/permanent AF in patients with SND.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results\u2014<\/jats:title>\n                    <jats:p>\n                      The Electrophysiology-Guided Pacing Site Selection (EPASS) Study was a prospective, controlled, randomized study. Atrial refractoriness, basal and incremental conduction times from the RAA to the coronary sinus ostium were measured before implantation, and the difference (\u0394CTos) was calculated. Patients with \u0394CTos \u226550 ms (study group) and those with \u0394CTos &lt;50 ms (control group) were randomly assigned to RAA or IAS with algorithms for continuous atrial stimulation \u201con.\u201d The primary end point was time to development of permanent or persistent AF within a 2-year follow-up in the study group, IAS versus RAA. Data were analyzed by intention to treat. One hundred two patients (77\u00b17 years, 44 mol\/L) were enrolled, 69 (68%) in the study group and 33 (32%) in the control group. Of these, 97 ended the study, respectively, randomly assigned: 29 IAS versus 36 RAA and 18 IAS versus 14 RAA. After a mean follow-up of 15\u00b17 (median, 17) months, 11 (16.6%) patients in the study group met the primary end point: 2 IAS versus 9 RAA (log rank=3.93,\n                      <jats:italic>P<\/jats:italic>\n                      =0.047).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions\u2014<\/jats:title>\n                    <jats:p>In patients with SND and intra-atrial conduction delay, low IAS pacing was superior to RAA pacing in preventing progression to persistent or permanent AF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial Registration\u2014<\/jats:title>\n                    <jats:p>\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.clinicaltrials.gov\">http:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n                      . Unique identifier: NCT00239226.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circep.110.957126","type":"journal-article","created":{"date-parts":[[2011,9,24]],"date-time":"2011-09-24T03:03:23Z","timestamp":1316833403000},"page":"844-850","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":45,"title":["Efficacy of Low Interatrial Septum and Right Atrial Appendage Pacing for Prevention of Permanent Atrial Fibrillation in Patients With Sinus Node Disease"],"prefix":"10.1161","volume":"4","author":[{"given":"Roberto","family":"Verlato","sequence":"first","affiliation":[{"name":"From the Cardiology Department, General Hospital, Camposampiero, Italy (PD) (R.V., M.S.B., P.T.); the Cardiology Department, S Anna Hospital, Como, Italy (G.L.B., G.R.); the Cardiology Department, Molinette Hospital, Torino, Italy (R.M., C.A.); the Cardiology Department, Presidi Ospedalieri Riuniti, Borgomanero, Italy (NO) (A.P.); the Cardiology Department, Cisanello Hospital, Pisa, Italy (M.G.B.); the Cardiology Department, Mirano Hospital, Mirano, Italy (VE) (E.B.); the Cardiology Department,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni Luca","family":"Botto","sequence":"additional","affiliation":[{"name":"From the Cardiology Department, General Hospital, Camposampiero, Italy (PD) (R.V., M.S.B., P.T.); the Cardiology Department, S Anna Hospital, Como, Italy (G.L.B., G.R.); the Cardiology Department, Molinette Hospital, Torino, Italy (R.M., C.A.); the Cardiology Department, Presidi Ospedalieri Riuniti, Borgomanero, Italy (NO) (A.P.); the Cardiology Department, Cisanello Hospital, Pisa, Italy (M.G.B.); the Cardiology Department, Mirano Hospital, Mirano, Italy (VE) (E.B.); the Cardiology Department,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Massa","sequence":"additional","affiliation":[{"name":"From the Cardiology Department, General Hospital, Camposampiero, Italy (PD) (R.V., M.S.B., P.T.); the Cardiology Department, S Anna Hospital, Como, Italy (G.L.B., G.R.); the Cardiology Department, Molinette Hospital, Torino, Italy (R.M., C.A.); the Cardiology Department, Presidi Ospedalieri Riuniti, Borgomanero, Italy (NO) (A.P.); the Cardiology Department, Cisanello Hospital, Pisa, Italy (M.G.B.); the Cardiology Department, Mirano Hospital, Mirano, Italy (VE) (E.B.); the Cardiology Department,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Amellone","sequence":"additional","affiliation":[{"name":"From the Cardiology Department, General Hospital, Camposampiero, Italy (PD) (R.V., M.S.B., P.T.); the Cardiology Department, S Anna Hospital, Como, Italy (G.L.B., G.R.); the Cardiology Department, Molinette Hospital, Torino, Italy (R.M., C.A.); the Cardiology Department, Presidi Ospedalieri Riuniti, Borgomanero, Italy (NO) (A.P.); the Cardiology Department, Cisanello Hospital, Pisa, Italy (M.G.B.); the Cardiology Department, Mirano Hospital, Mirano, Italy (VE) (E.B.); the Cardiology Department,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonello","family":"Perucca","sequence":"additional","affiliation":[{"name":"From the Cardiology Department, General Hospital, Camposampiero, Italy (PD) (R.V., M.S.B., P.T.); the Cardiology Department, S Anna Hospital, Como, Italy (G.L.B., G.R.); the Cardiology Department, Molinette Hospital, Torino, Italy (R.M., C.A.); the Cardiology Department, Presidi Ospedalieri Riuniti, Borgomanero, Italy (NO) (A.P.); the Cardiology Department, Cisanello Hospital, Pisa, Italy (M.G.B.); the Cardiology Department, Mirano Hospital, Mirano, Italy (VE) (E.B.); the Cardiology Department,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Grazia","family":"Bongiorni","sequence":"additional","affiliation":[{"name":"From the Cardiology Department, General Hospital, Camposampiero, Italy (PD) (R.V., M.S.B., P.T.); the Cardiology Department, S Anna Hospital, Como, Italy (G.L.B., G.R.); the Cardiology Department, Molinette Hospital, Torino, Italy (R.M., C.A.); the Cardiology Department, Presidi Ospedalieri Riuniti, Borgomanero, Italy (NO) (A.P.); the Cardiology Department, Cisanello Hospital, Pisa, Italy (M.G.B.); the Cardiology Department, Mirano Hospital, Mirano, Italy (VE) (E.B.); the Cardiology Department,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuele","family":"Bertaglia","sequence":"additional","affiliation":[{"name":"From the Cardiology Department, General Hospital, Camposampiero, Italy (PD) (R.V., M.S.B., P.T.); the Cardiology Department, S Anna Hospital, Como, Italy (G.L.B., G.R.); the Cardiology Department, Molinette Hospital, Torino, Italy (R.M., C.A.); the Cardiology Department, Presidi Ospedalieri Riuniti, Borgomanero, Italy (NO) (A.P.); the Cardiology Department, Cisanello Hospital, Pisa, Italy (M.G.B.); the Cardiology Department, Mirano Hospital, Mirano, Italy (VE) (E.B.); the Cardiology Department,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vigilio","family":"Ziacchi","sequence":"additional","affiliation":[{"name":"From the Cardiology Department, General Hospital, Camposampiero, Italy (PD) (R.V., M.S.B., P.T.); the Cardiology Department, S Anna Hospital, Como, Italy (G.L.B., G.R.); the Cardiology Department, Molinette Hospital, Torino, Italy (R.M., C.A.); the Cardiology Department, Presidi Ospedalieri Riuniti, Borgomanero, Italy (NO) (A.P.); the Cardiology Department, Cisanello Hospital, Pisa, Italy (M.G.B.); the Cardiology Department, Mirano Hospital, Mirano, Italy (VE) (E.B.); the Cardiology Department,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcello","family":"Piacenti","sequence":"additional","affiliation":[{"name":"From the Cardiology Department, General Hospital, Camposampiero, Italy (PD) (R.V., M.S.B., P.T.); the Cardiology Department, S Anna Hospital, Como, Italy (G.L.B., G.R.); the Cardiology Department, Molinette Hospital, Torino, Italy (R.M., C.A.); the Cardiology Department, Presidi Ospedalieri Riuniti, Borgomanero, Italy (NO) (A.P.); the Cardiology Department, Cisanello Hospital, Pisa, Italy (M.G.B.); the Cardiology Department, Mirano Hospital, Mirano, Italy (VE) (E.B.); the Cardiology Department,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Attilio","family":"Del Rosso","sequence":"additional","affiliation":[{"name":"From the Cardiology Department, General Hospital, Camposampiero, Italy (PD) (R.V., M.S.B., P.T.); the Cardiology Department, S Anna Hospital, Como, Italy (G.L.B., G.R.); the Cardiology Department, Molinette Hospital, Torino, Italy (R.M., C.A.); the Cardiology Department, Presidi Ospedalieri Riuniti, Borgomanero, Italy (NO) (A.P.); the Cardiology Department, Cisanello Hospital, Pisa, Italy (M.G.B.); the Cardiology Department, Mirano Hospital, Mirano, Italy (VE) (E.B.); the Cardiology Department,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Russo","sequence":"additional","affiliation":[{"name":"From the Cardiology Department, General Hospital, Camposampiero, Italy (PD) (R.V., M.S.B., P.T.); the Cardiology Department, S Anna Hospital, Como, Italy (G.L.B., G.R.); the Cardiology Department, Molinette Hospital, Torino, Italy (R.M., C.A.); the Cardiology Department, Presidi Ospedalieri Riuniti, Borgomanero, Italy (NO) (A.P.); the Cardiology Department, Cisanello Hospital, Pisa, Italy (M.G.B.); the Cardiology Department, Mirano Hospital, Mirano, Italy (VE) (E.B.); the Cardiology Department,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Stella","family":"Baccillieri","sequence":"additional","affiliation":[{"name":"From the Cardiology Department, General Hospital, Camposampiero, Italy (PD) (R.V., M.S.B., P.T.); the Cardiology Department, S Anna Hospital, Como, Italy (G.L.B., G.R.); the Cardiology Department, Molinette Hospital, Torino, Italy (R.M., C.A.); the Cardiology Department, Presidi Ospedalieri Riuniti, Borgomanero, Italy (NO) (A.P.); the Cardiology Department, Cisanello Hospital, Pisa, Italy (M.G.B.); the Cardiology Department, Mirano Hospital, Mirano, Italy (VE) (E.B.); the Cardiology Department,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Turrini","sequence":"additional","affiliation":[{"name":"From the Cardiology Department, General Hospital, Camposampiero, Italy (PD) (R.V., M.S.B., P.T.); the Cardiology Department, S Anna Hospital, Como, Italy (G.L.B., G.R.); the Cardiology Department, Molinette Hospital, Torino, Italy (R.M., C.A.); the Cardiology Department, Presidi Ospedalieri Riuniti, Borgomanero, Italy (NO) (A.P.); the Cardiology Department, Cisanello Hospital, Pisa, Italy (M.G.B.); the Cardiology Department, Mirano Hospital, Mirano, Italy (VE) (E.B.); the Cardiology Department,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgio","family":"Corbucci","sequence":"additional","affiliation":[{"name":"From the Cardiology Department, General Hospital, Camposampiero, Italy (PD) (R.V., M.S.B., P.T.); the Cardiology Department, S Anna Hospital, Como, Italy (G.L.B., G.R.); the Cardiology Department, Molinette Hospital, Torino, Italy (R.M., C.A.); the Cardiology Department, Presidi Ospedalieri Riuniti, Borgomanero, Italy (NO) (A.P.); the Cardiology Department, Cisanello Hospital, Pisa, Italy (M.G.B.); the Cardiology Department, Mirano Hospital, Mirano, Italy (VE) (E.B.); 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