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November 1, 1988Pacing and Clinical Electrophysiology

Atrial Fibrillation and Embolic Complications in Paced Patients

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Why the study?

Does VVI pacing increase the risk of atrial fibrillation and embolic complications in pacemaker patients compared to dual chamber pacing?

Population

246 pacemaker patients with sinus rhythm at implantation

Comparison

VVI pacemaker (n=203) vs Dual chamber pacemaker (n=43)

Design

Cohort

Follow-up

mean 63 +/- 45 months

Authors

HLH. LangenfeldUniversitätsklinikum WürzburgWGWolfram GrimmPhilipps University of MarburgBMBernhard MaischGeneral Cardiology

Discussion

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Overview

Higher AF incidence after pacing for sick sinus syndrome supports targeted monitoring; leaves open VVI versus dual-chamber effects on embolism.

Structured PICO

Does VVI pacing increase the risk of atrial fibrillation and embolic complications in pacemaker patients compared to dual chamber pacing?

P
Population
246 pacemaker patients with sinus rhythm at implantation (indications: second and third degree AV block n=111, sick sinus syndrome n=101, other indications n=34)
I
Intervention
VVI pacemaker (n=203)
C
Comparator
Dual chamber pacemaker (n=43)
O
Outcome
Incidence of atrial fibrillation and thromboembolic complications (stroke or transitory ischemic attacks)hard clinical

VVI pacing is associated with a high long-term incidence of atrial fibrillation, particularly in patients with sick sinus syndrome, likely due to retrograde conduction.

Limitations

  • Survival bias (cannot exclude that some patients were lost due to severe stroke)
  • Shorter implantation time for dual chamber devices

Cite This Study

Langenfeld et al. (1988) studied this question.

synapsesocial.com/papers/6a73bfb7e3ef2a9a940dd149https://doi.org/10.1111/j.1540-8159.1988.tb06292.x
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Also Consider

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

  1. 1Atrial pacing in the management of sick sinus syndrome: Long-term observation for conduction disturbances and supraventricular tachyarrhythmias1986 · 19 citations
  2. 2Systemic Embolism in Chronic Sinoatrial Disorder1976 · 164 citations
  3. 3Sick Sinus Syndrome Treated with Permanent Pacemaker in 109 Patients1979 · 73 citations
  4. 4Thromboembolism in Patients With Atrial Fibrillation1984 · 141 citations
  5. 5Duration of atrial fibrillation and imminence of stroke: the Framingham study.1983 · 340 citations