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August 7, 2011Pacing and Clinical Electrophysiology

The Influence of Atrial and Ventricular Pacing on the Incidence of Atrial Fibrillation: A Meta‐Analysis

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Why the study?

Does increased atrial and ventricular pacing increase the incidence of atrial fibrillation in patients with sinus node dysfunction?

Population

1,507 patients with sinus node dysfunction from four contemporary pacemaker studies. Excluded: patients with…

Comparison

Higher percentages of atrial pacing and… vs Lower percentages of atrial and ventricular pacing

Design

Meta-analysis

Follow-up

mean 14.3 ± 8.7 months

Authors

LELior U. ElkayamJKJodi KoehlerTSTodd Sheldon

Discussion

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Overview

Elevated atrial pacing burden warrants closer AF monitoring in sinus node dysfunction; extends meta-analytic evidence linking %AP to arrhythmia risk.

Structured PICO

Does increased atrial and ventricular pacing increase the incidence of atrial fibrillation in patients with sinus node dysfunction?

P
Population
1,507 patients with sinus node dysfunction (SND) from four contemporary pacemaker studies. Excluded: patients with >5 minutes of atrial fibrillation at the first visit.
I
Intervention
Higher percentages of atrial pacing (%AP) and ventricular pacing (%VP)
C
Comparator
Lower percentages of atrial and ventricular pacing (first quartiles: 0-32% for AP, 0-2% for VP)
O
Outcome
7 consecutive days of atrial fibrillationhard clinical

In patients with sinus node dysfunction, higher percentages of both atrial and ventricular pacing are associated with an increased incidence of atrial fibrillation.

Cite This Study

Elkayam et al. (2011) studied this question.

synapsesocial.com/papers/6a0fbda396ccf432805fc212https://doi.org/10.1111/j.1540-8159.2011.03192.x
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Conventional and dedicated atrial overdrive pacing for the prevention of paroxysmal atrial fibrillation: the AFTherapy study2007 · 56 citations
  2. 2Effects of Biatrial Pacing in Prevention of Postoperative Atrial Fibrillation After Coronary Artery Bypass Surgery2000 · 165 citations
  3. 3Impact of atrial antitachycardia pacing and atrial pace prevention therapies on atrial fibrillation burden over long-term follow-up2009 · 19 citations
  4. 4Atrial Electromechanical Sequence and Contraction Synchrony during Single‐ and Multisite Atrial Pacing in Patients with Brady‐Tachycardia Syndrome2009 · 25 citations
  5. 5Interventions for preventing post-operative atrial fibrillation in patients undergoing heart surgery2013 · 514 citations