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

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    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.
    Issue Date
    2012-01-31T16:40:09Z
    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
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    Metadata
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    Citation
    Croat Med J. 2011 Feb;52(1):61-7.
    Journal
    Croatian medical journal
    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
    ISSN
    1332-8166 (Electronic)
    0353-9504 (Linking)
    Collections
    Mercy University Hospital

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