Key result
Elevated LV stiffness index is linked to ~50% higher new-onset AF risk in dual-chamber pacemakers.
Why the study?
Patients with permanent pacemakers frequently develop atrial fibrillation, but echocardiographic and clinical predictors of AF in this population are not well defined.
Do baseline echocardiographic parameters (LVSI, DWS) predict the development of atrial fibrillation in patients with dual-chamber permanent pacemakers?
Cohort (n=208)
No
Do baseline echocardiographic parameters (LVSI, DWS) predict the development of atrial fibrillation in patients with dual-chamber permanent pacemakers?
Echocardiographic parameters LVSI and DWS can predict the development of atrial fibrillation in patients with dual-chamber pacemakers, potentially aiding in stroke risk stratification and timely anticoagulation.
Answers are grounded in this paper and cite their sources.
LV stiffness markers may stratify AF risk in dual-chamber pacemaker patients; hypothesis-generating and requires prospective validation before clinical use.
Background and Objectives: 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.Methods: 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.Results: 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.Conclusion: 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 a cohort in Sinus node dysfunction or atrioventricular block requiring dual-chamber pacemaker (n=208). Left ventricular stiffness index (LVSI) vs. Lower LVSI was evaluated on Occurrence of atrial fibrillation (HR 1.5, 95% CI 2.301-0.637, p=<0.001). Increased left ventricular stiffness index (HR 1.5) and reduced diastolic wall strain (HR 0.8) were independent predictors of new-onset atrial fibrillation in patients with dual-chamber pacemakers.
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