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Atrial fibrillation after DDDR pacemaker implantation
Anne M Gillis1, Margaret Morck
1Cardiovascular Research Group and the Division of Cardiology, The University of Calgary and Foothills Medical Centre, Alberta, Canada. amgillis@ucalgary.ca
Journal of Cardiovascular Electrophysiology
|July 11, 2002
Summary
Atrial fibrillation (AF) frequently develops after dual-chamber pacemaker implantation. AF burden increases over time, particularly in patients with sinus node disease.
Area of Science:
- Cardiology
- Biomedical Engineering
Background:
- Modern implantable pulse generators can store data, enabling detection of multiple atrial fibrillation (AF) episodes.
- Understanding AF development in pacemaker patients is crucial for managing cardiovascular health.
Purpose of the Study:
- To evaluate clinical predictors of AF development in a general pacemaker population.
- To analyze the time course and burden of AF after dual-chamber pacemaker implantation.
Main Methods:
- 231 patients received DDDR pacemakers with AF detection and storage capabilities.
- Follow-up duration was 718+/-383 days, assessing time to first AF, interval between episodes, and total AF burden.
- Statistical analysis identified predictors of AF occurrence and burden progression.
Main Results:
- AF occurred in 68% of patients with sinus node disease versus 37% with AV block (P < 0.001).
- The time to first AF occurrence was 21.2 days post-implantation.
- AF burden initially decreased but significantly increased long-term (2.0 hours/day at 48 months), especially in sinus node disease patients.
- Prior AF history and follow-up duration predicted AF occurrence.
Conclusions:
- Atrial fibrillation is common following dual-chamber pacemaker implantation.
- AF burden shows a progressive increase over the long term, necessitating ongoing monitoring.