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October 1, 2024Internal MedicineOpen Access

Incidence and Clinical Predictors of Atrial Fibrillation in Patients with Dual-Chamber Pacemakers: A Retrospective Analysis

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Key result

In patients with dual-chamber pacemakers and no prior history of atrial fibrillation, the incidence of atrial high-rate episodes was 13.19% over 12 to 18 months, significantly predicted by advanced age and higher systolic blood pressure.

Why the study?

Paroxysmal AF is often asymptomatic and risks delayed diagnosis, but dual-chamber pacemakers enable continuous rhythm monitoring to detect subclinical AF and identify clinical predictors of its development.

Population

91 patients from the Oltenia region receiving dual-chamber pacemakers with no prior AF history

Design

Retrospective cohort study

Follow-up

12 to 18 months

Authors

CNCristina Elena NegroiuADAnca Oana DoceaEGEmilia-Violeta Goanţă

Discussion

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Overview

May warrant closer AHRE surveillance in older hypertensive pacemaker patients; hypothesis-generating for anticoagulation trials.

Key Points

  • To evaluate the incidence of new-onset atrial fibrillation and atrial high-rate episodes, and to identify associated clinical predictors in patients receiving dual-chamber pacemakers.
  • Retrospective analysis of N=91 patients in the Oltenia region undergoing dual-chamber pacemaker implantation for atrioventricular block or sick sinus syndrome without prior history of atrial fibrillation.
  • Continuous device monitoring evaluated atrial rhythms over a post-implantation follow-up period of 12 to 18 months.
  • Atrial high-rate episodes were newly detected in 13.19% of patients during the 12- to 18-month monitoring period.
  • Advanced age and preexisting hypertension were identified as statistically significant clinical predictors for developing atrial high-rate episodes.

Study Design

Type

Cohort (n=91)

Multicenter

No

Structured PICO

P
Population
91 adult patients requiring dual-chamber cardiac pacing without prior atrial fibrillation, followed for 12 to 18 months to monitor the incidence of atrial high-rate episodes.
E
Exposure
Dual-chamber pacemaker implantation with continuous monitoring
O
Outcome
Incidence of atrial high-rate episodes (AHRE) or atrial fibrillation and identification of clinical predictors

Continuous monitoring via dual-chamber pacemakers detects subclinical atrial fibrillation (AHRE) in approximately 13% of patients without prior AF, particularly in older patients with hypertension.

Limitations

  • Single-center retrospective cohort study
  • Small sample size
  • Short mean follow-up period
  • Pacemaker default settings for AF detection differed slightly between different models
  • limited sample size

Cite This Study

Negroiu et al. (2024) conducted a cohort in Indications for permanent cardiac pacing without prior atrial fibrillation (n=91). Dual-chamber pacemaker implantation was evaluated on Incidence of atrial high-rate episodes (AHRE). In patients with dual-chamber pacemakers and no prior history of atrial fibrillation, the incidence of atrial high-rate episodes was 13.19% over 12 to 18 months, significantly predicted by advanced age and higher systolic blood pressure.

synapsesocial.com/papers/6a9a42956bb205df309e5b97https://doi.org/10.2478/inmed-2024-0295
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Also Consider

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

  1. 1Incidence of atrial high rate episodes after dual-chamber permanent pacemaker implantation and its clinical predictors2022 · 7 citations
  2. 2Review of the epidemiology, pathogenesis and prevention of atrial fibrillation after pacemaker implantation2023 · 8 citations
  3. 3Automatic analysis of pacemaker diagnostic data in the identification of atrial tachyarrhythmias in patients with no prior history of them2005 · 18 citations
  4. 4Association of Atrial Fibrillation Burden and Mortality Among Patients With Cardiac Implantable Electronic Devices2024 · 20 citations
  5. 5Hypertension and Atrial Fibrillation: An Intimate Association of Epidemiology, Pathophysiology, and Outcomes2017 · 91 citations