Device-detected atrial fibrillation episodes longer than one day were independently associated with an increased risk of arterial embolism (OR 3.1; 95% CI 1.1-10.5; p=0.044).
Cohort (n=725)
Does device-detected atrial fibrillation duration longer than one day predict arterial embolic events in patients with bradycardia and atrial fibrillation implanted with antitachycardia pacemakers?
In patients with pacemakers, device-detected atrial fibrillation episodes lasting longer than one day are independently associated with a significantly increased risk of arterial embolic events.
Odds Ratio: 3.1 (95% CI 1.1–10.5)
p-value: p=0.044
Monitored atrial fibrillation duration predicts arterial embolic events in patients suffering from bradycardia and atrial fibrillation implanted with antitachycardia pacemakers. Capucci A; Santini M; Padeletti L; Gulizia M; Botto G; BORIANI, Giuseppe ; Ricci R; Favale S; Zolezzi F; Di Belardino N; Molon G; Drago F; Villani GQ; Mazzini E; Vimercati M; Grammatico A. 2006 Abstract The aim of our study was to evaluate arterial embolism (AE) occurrence rates and predictors in patients suffering from bradycardia and wearing a pacemaker with antitachycardia pacing therapies. BACKGROUND: Atrialfibrillation (AF) is associated with a high incidence of AE. METHODS: A total of725 patients (360 men, age 71 +/- 11 years) were implanted with a DDDRP pacemaker (Medtronic AT500, Medtronic Inc., Minneapolis, Minnesota). At baseline 225 (31.0%) patients received antiplatelet therapy and 264 (36.4%) patients received anticoagulation agents. RESULTS: Over a median 22-month follow-up (25th to 75th interquartile range 16 to 30 months), AE occurred in 14 (1.9%) patients: 7 patients suffered a nonfatal ischemic stroke (0.6% per year), 4 patients had transient ischemic attack (0.34% per year), and 3 patients had embolic complications. Among baseline patients' characteristics, multivariate logistic analysis showed that embolic events are independently associated to ischemic heart disease (7.0 odds ratio OR, 95% confidence interval CI 2.3 to 21.3, p = 0.001), prior embolic event (7.3 OR, 95% CI 1.2 to 43.9, p = 0.029), diabetes (5.0 OR, 95% CI 1.2 to 15.7, p = 0.032), and hypertension (4.1 OR, 95% CI 1.1 to 15.6, p = 0.036). The risk of embolism, adjusted for known risk factors, was 3.1 times increased (95% CI 1.1 to 10.5, p = 0.044) in patients with device-detected atrial fibrillation episodes longer than one day during follow-up. CONCLUSIONS: In a cohort of patients with bradycardia and AF, arterial embolism was common in patients with ischemic cardiopathy, hypertension, diabetes mellitus, and in patients with known stroke risk factors. Atrial fibrillation occurrences longer than one day were independently associated with embolic events.
Capucci et al. (Tue,) conducted a cohort in Bradycardia and atrial fibrillation (n=725). Device-detected atrial fibrillation episodes longer than one day vs. No atrial fibrillation episodes longer than one day was evaluated on Arterial embolism (OR 3.1, 95% CI 1.1-10.5, p=0.044). Device-detected atrial fibrillation episodes longer than one day were independently associated with an increased risk of arterial embolism (OR 3.1; 95% CI 1.1-10.5; p=0.044).