What does this research mean for the field?

Atrial fibrillation is frequent among pacemaker patients yet anticoagulation remains underutilized despite high thromboembolic risk, with treatment heavily driven by the presence of arrhythmia at the time of implantation. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

June 28, 2011EP EuropaceOpen Access

Pacemaker clinic: an opportunity to detect silent atrial fibrillation and improve antithrombotic treatment

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Pacemakers and Atrial Fibrillation (n=585). Intervention: Arrhythmia at the time of implantation vs. No arrhythmia at implantation. Primary outcome: Use of anticoagulant treatment in cases with CHADS2 > 2 (OR 4.25, 95% CI 1.72-10.51, p=0.002).

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Key result

Arrhythmia at pacemaker implantation linked to ~325% greater anticoagulation use in patients with CHADS2 >2.

OR 4.25
95% CI 1.72-10.51
P=0.002
n=585

Study Design

Type

Observational (n=585)

Multicenter

Structured PICO

Population

585 patients with pacemakers evaluated at a single institution in 2008, monitored over an average of 5.5 years to assess atrial fibrillation prevalence and antithrombotic treatment.

Exposure

Pacemaker interrogation to detect atrial fibrillation and assessment of antithrombotic treatment appropriateness

Outcome

Prevalence of atrial fibrillation and rate of appropriate antithrombotic treatment

Main Result

Odds Ratio: 4.25 (95% CI 1.72–10.51)

p-value: p=0.002

Silent atrial fibrillation is highly prevalent in pacemaker patients, but anticoagulant therapy is significantly underutilized despite high embolic risk.

Discussion

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Implication

May inform anticoagulation decisions in high-CHADS2 pacemaker patients; leaves open outcome impact and requires prospective validation.

Cite This Study

Mercé et al. (2011) conducted an observational in Pacemakers and Atrial Fibrillation (n=585). Arrhythmia at the time of implantation vs. No arrhythmia at implantation was evaluated on Use of anticoagulant treatment in cases with CHADS2 > 2 (OR 4.25, 95% CI 1.72-10.51, p=0.002). Among pacemaker patients with CHADS2 >2, arrhythmia at implantation was significantly associated with receiving anticoagulant treatment (OR 4.25; 95% CI 1.72-10.51; P=0.002).

synapsesocial.com/papers/6aa5547a9feada129378e306 https://doi.org/10.1093/europace/eur160

Topics

Atrial fibrillation Persistent AF management Anticoagulation in AF AF ablation outcomes

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Pacemaker clinic: an opportunity to detect silent atrial fibrillation and improve antithrombotic treatment

Study Design

Structured PICO

Main Result

Discussion

Implication

Cite This Study

Topics

Pacemaker clinic: an opportunity to detect silent atrial fibrillation and improve antithrombotic treatment

Study Design

Structured PICO

Main Result

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider