Incidence and predictors of asymptomatic atrial fibrillation in patients older than 70 years with complete atrioventricular block and dual chamber pacemaker implantation.
Authors
Radeljic, VjekoslavPavlovic, 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
2012-01-31T16:40:09ZMeSH
AgedAged, 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
Metadata
Show full item recordCitation
Croat Med J. 2011 Feb;52(1):61-7.Journal
Croatian medical journalPubMed ID
21328722Abstract
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
engISSN
1332-8166 (Electronic)0353-9504 (Linking)