Incidence and predictors of asymptomatic atrial fibrillation in patients older than 70 years with complete atrioventricular block and dual chamber pacemaker implantation.

2.50
Hdl Handle:
http://hdl.handle.net/10147/206360
Title:
Incidence and predictors of asymptomatic atrial fibrillation in patients older than 70 years with complete atrioventricular block and dual chamber pacemaker implantation.
Authors:
Radeljic, Vjekoslav; Pavlovic, Nikola; Manola, Sime; Delic-Brkljacic, Diana; Pintaric, Hrvoje; Petrac, Dubravko
Affiliation:
Department of Cardiology, Sisters of Mercy University Hospital Center,, Vinogradska cesta 29, 10000 Zagreb, Croatia.
Citation:
Croat Med J. 2011 Feb;52(1):61-7.
Journal:
Croatian medical journal
Issue Date:
31-Jan-2012
URI:
http://hdl.handle.net/10147/206360
PubMed ID:
21328722
Abstract:
AIM: To evaluate predictors of asymptomatic atrial fibrillation in patients older than 70 years with complete atrioventricular (AV) block, normal left ventricular systolic function, and implanted dual chamber (DDD) pacemaker. METHODS: Hundred and eighty six patients with complete AV block were admitted over one year to the Sisters of Mercy University Hospital. The study recruited patients older than 70 years, with no history of atrial fibrillation, heart failure, or reduced left ventricular systolic function. All the patients were implanted with the same pacemaker. Out of 103 patients who were eligible for the study, 81 (78%) were evaluated. Among those 81 (78%) were evaluated. Eighty one (78%) patients were evaluated. Follow-up time ranged from 12 to 33 months (average +/-standard deviation 23 +/- 5 months). Primary end-point was asymptomatic atrial fibrillation occurrence recorded by the pacemaker. Atrial fibrillation occurrence was defined as atrial high rate episodes (AHRE) lasting >5 minutes. Binary logistic regression was used to identify the predictors of development of asymptomatic atrial fibrillation. Results. The 81 patients were stratified into two groups depending on the presence of AHRE lasting >5 minutes (group 1 had AHRE>5 minutes and group 2 AHRE<5 minutes). AHRE lasting >5 minutes were detected in 49 (60%) patients after 3 months and in 53 (65%) patients after 18 moths. After 3 months, only hypertension (odds ratio [OR], 17.63; P = 0.020) was identified as a predictor of asymptomatic atrial fibrillation. After 18 months, hypertension (OR, 14.0; P = 0.036), P wave duration >100 ms in 12 lead ECG (OR, 16.5; P = 0.001), and intracardial atrial electrogram signal amplitude >4 mV (OR, 4.27; P = 0.045) were identified as predictors of atrial fibrillation. CONCLUSION: In our study population, hypertension was the most robust and constant predictor of asymptomatic atrial fibrillation after 3 months, while P wave duration >100 ms in 12-lead ECG and intracardial atrial signal amplitude were predictors after 18 months.
Language:
eng
MeSH:
Aged; Aged, 80 and over; Asymptomatic Diseases; *Atrial; Fibrillation/diagnosis/epidemiology/etiology/pathology/physiopathology/therapy; Atrioventricular Block/*complications/physiopathology/therapy; *Electrocardiography; Female; Follow-Up Studies; *Heart Conduction System/pathology/physiopathology; Humans; Hypertension/*complications; Incidence; Male; *Pacemaker, Artificial; Risk Factors
ISSN:
1332-8166 (Electronic); 0353-9504 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorRadeljic, Vjekoslaven_GB
dc.contributor.authorPavlovic, Nikolaen_GB
dc.contributor.authorManola, Simeen_GB
dc.contributor.authorDelic-Brkljacic, Dianaen_GB
dc.contributor.authorPintaric, Hrvojeen_GB
dc.contributor.authorPetrac, Dubravkoen_GB
dc.date.accessioned2012-01-31T16:40:09Z-
dc.date.available2012-01-31T16:40:09Z-
dc.date.issued2012-01-31T16:40:09Z-
dc.identifier.citationCroat Med J. 2011 Feb;52(1):61-7.en_GB
dc.identifier.issn1332-8166 (Electronic)en_GB
dc.identifier.issn0353-9504 (Linking)en_GB
dc.identifier.pmid21328722en_GB
dc.identifier.urihttp://hdl.handle.net/10147/206360-
dc.description.abstractAIM: To evaluate predictors of asymptomatic atrial fibrillation in patients older than 70 years with complete atrioventricular (AV) block, normal left ventricular systolic function, and implanted dual chamber (DDD) pacemaker. METHODS: Hundred and eighty six patients with complete AV block were admitted over one year to the Sisters of Mercy University Hospital. The study recruited patients older than 70 years, with no history of atrial fibrillation, heart failure, or reduced left ventricular systolic function. All the patients were implanted with the same pacemaker. Out of 103 patients who were eligible for the study, 81 (78%) were evaluated. Among those 81 (78%) were evaluated. Eighty one (78%) patients were evaluated. Follow-up time ranged from 12 to 33 months (average +/-standard deviation 23 +/- 5 months). Primary end-point was asymptomatic atrial fibrillation occurrence recorded by the pacemaker. Atrial fibrillation occurrence was defined as atrial high rate episodes (AHRE) lasting >5 minutes. Binary logistic regression was used to identify the predictors of development of asymptomatic atrial fibrillation. Results. The 81 patients were stratified into two groups depending on the presence of AHRE lasting >5 minutes (group 1 had AHRE>5 minutes and group 2 AHRE<5 minutes). AHRE lasting >5 minutes were detected in 49 (60%) patients after 3 months and in 53 (65%) patients after 18 moths. After 3 months, only hypertension (odds ratio [OR], 17.63; P = 0.020) was identified as a predictor of asymptomatic atrial fibrillation. After 18 months, hypertension (OR, 14.0; P = 0.036), P wave duration >100 ms in 12 lead ECG (OR, 16.5; P = 0.001), and intracardial atrial electrogram signal amplitude >4 mV (OR, 4.27; P = 0.045) were identified as predictors of atrial fibrillation. CONCLUSION: In our study population, hypertension was the most robust and constant predictor of asymptomatic atrial fibrillation after 3 months, while P wave duration >100 ms in 12-lead ECG and intracardial atrial signal amplitude were predictors after 18 months.en_GB
dc.language.isoengen_GB
dc.subject.meshAgeden_GB
dc.subject.meshAged, 80 and overen_GB
dc.subject.meshAsymptomatic Diseasesen_GB
dc.subject.mesh*Atrialen_GB
dc.subject.meshFibrillation/diagnosis/epidemiology/etiology/pathology/physiopathology/therapyen_GB
dc.subject.meshAtrioventricular Block/*complications/physiopathology/therapyen_GB
dc.subject.mesh*Electrocardiographyen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshFollow-Up Studiesen_GB
dc.subject.mesh*Heart Conduction System/pathology/physiopathologyen_GB
dc.subject.meshHumansen_GB
dc.subject.meshHypertension/*complicationsen_GB
dc.subject.meshIncidenceen_GB
dc.subject.meshMaleen_GB
dc.subject.mesh*Pacemaker, Artificialen_GB
dc.subject.meshRisk Factorsen_GB
dc.titleIncidence and predictors of asymptomatic atrial fibrillation in patients older than 70 years with complete atrioventricular block and dual chamber pacemaker implantation.en_GB
dc.contributor.departmentDepartment of Cardiology, Sisters of Mercy University Hospital Center,, Vinogradska cesta 29, 10000 Zagreb, Croatia.en_GB
dc.identifier.journalCroatian medical journalen_GB
dc.description.provinceMunster-

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