Key result
High LV stiffness index linked to ~50% increased AF risk in dual-chamber pacemaker patients.
Why the study?
Patients with permanent dual-chamber pacemakers frequently develop atrial fibrillation, but clinical and echocardiographic predictors of AF in this population are not well defined.
Do echocardiographic parameters (LVSI and DWS) predict the development of atrial fibrillation in patients with dual-chamber permanent pacemakers?
Observational (n=208)
No
Do echocardiographic parameters (LVSI and DWS) predict the development of atrial fibrillation in patients with dual-chamber permanent pacemakers?
Left ventricular stiffness index and diastolic wall strain are simple echocardiographic predictors for the development of atrial fibrillation in patients with dual-chamber pacemakers, which may help guide timely anticoagulation.
Answers are grounded in this paper and cite their sources.
May aid AF risk stratification in pacemaker patients; hypothesis-generating and requires prospective validation before guiding anticoagulation.
Patients on implanted permanent pacemakers frequently develop atrial fibrillation (AF). We aimed to determine the Echocardiographic and clinical parameters predicting AF in patients with a dual-chamber (DDD) pacemaker. This retrospective study included 208 patients with permanent pacemaker, classified according to development of AF during follow up into 2 groups: AF (77, 37%) and non AF (131, 63%), baseline: clinical, ECG(P-wave dispersion) and echo {diastolic wall strain (DWS),left arial volume index (LAVI), left ventricular stiffness index(LVSI)} data were assessed. AF group were older with more P wave dispersion, lesser DWS, greater LVSI& LAVI, LVSI at a cut off > 0.13 and DWS at a cut off < 0.34 were predictors of AF in patients with DDD pacemakers. LVSI and DWS could be used as simple good predictors for AF in patients with DDD pacemakers, for timely initiation of anticoagulants according to CHA2DS2VASc score to decrease ischemic stroke burden.
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El‐Dosouky et al. (2022) conducted an observational in Sinus node dysfunction or atrioventricular block requiring permanent pacemaker (n=208). Left ventricular stiffness index (LVSI) vs. Lower LVSI was evaluated on Development of atrial fibrillation (AF) (HR 1.5, 95% CI 0.637-2.301, p=<0.001). Left ventricular stiffness index > 0.13 and diastolic wall strain < 0.34 independently predicted the development of atrial fibrillation in patients with dual-chamber pacemakers.
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