Izvorni znanstveni članak
Incidence and predictors of asymptomatic atrial fibrillation in patients older than 70 years with complete atrioventricular block and dual chamber pacemaker implantation
Vjekoslav Radeljić
; Department of Cardiology, Sisters of Mercy University Hospital, Zagreb, Croatia
Nikola Pavlović
orcid.org/0000-0001-9187-7681
; Department of Cardiology, Sisters of Mercy University Hospital, Zagreb, Croatia
Šime Manola
; Department of Cardiology, Sisters of Mercy University Hospital, Zagreb, Croatia
Diana Delić-Brkljačić
; Department of Cardiology, Sisters of Mercy University Hospital, Zagreb, Croatia
Hrvoje Pintarić
; Department of Cardiology, Sisters of Mercy University Hospital, Zagreb, Croatia
Dubravko Petrač
; Department of Cardiology, Sisters of Mercy University Hospital, Zagreb, Croatia
Sažetak
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.
Ključne riječi
asymptomatic atrial fibrillation; cardiac pacemaker; complete AV block; arterial hypertension
Hrčak ID:
78193
URI
Datum izdavanja:
15.2.2011.
Posjeta: 1.589 *