Prevalence of Atrial Fibrillation in Pacemaker Patients

Abstract

Background: Current pacemakers allow for the continuous recording of the occurrence of arrhythmic events. One of the most frequent arrhythmias after implantation of a device is atrial fibrillation (AF), an important risk factor for embolic events. The frequency of this arrhythmia in pacemaker patients has not been widely studied.Objectives: This study aimed to evaluate the prevalence, incidence, and predictors of the occurrence of AF in patients with double-chamber pacemakers and without a history of atrial fibrillation prior to implantation.Methods: A dynamic, retrospective, and prospective cohort study was carried out with 186 patients undergoing biannual follow-up of the double-chamber pacemaker, without previous AF, in a single service, between 2016 and 2018. Clinical data were collected from the medical records and the telemetry of the device and the prevalence, incidence rate, relative risk by univariate analysis (by chi-square), and risk ratio were calculated by multivariate analysis (by Cox regression); values of p<0.05 were considered significant.Results: There was a prevalence of 25.3% FA, with an incidence of 5.64 cases / 100 persons-year. The median time for the development of arrhythmia was 27.5 months. Multivariate analysis identified 5 statistically significant predictors: male gender, OR: 2.54 [1.04-6.15]; coronary artery disease, OR: 2.98 hypothyroidism,; prior heart surgery, OR: 2.67 [1.01-7]; and left atrial enlargement, OR: 2.72 [1.25-5.92]. Conclusion:The prevalence and incidence of AF in this population are high. Risk factors for AF were: male gender, coronary artery disease, hypothyroidism, prior heart surgery, and left atrial enlargement.

Prevalence of metabolic syndrome and its association with atrial arrhythmias in patients with implanted permanent pacemaker for cardiac conduction abnormality

“… 13 Another study by Mario Augusto Cray da Costa documented that the prevalence of AF post-PPI was 25 %. 14 Multivariable logistic regression analysis showed that metabolic syndrome, age, coronary artery disease and systolic BP were good independent predictors of atrial arrhythmias among patients who underwent permanent pacemaker implantation. Metabolic syndrome is an important key factor in the final common pathway of the atrial fibrillation pathogenesis which includes atrial structural/electrical remodeling, inflammatory processes, along with cardiac autonomic changes.…”

Estatística Cardiovascular – Brasil 2023

“…220 Em outro estudo de 186 portadores de marca-passo de um único centro no sul do Brasil [52% mulheres; mediana de idade, 67 anos (IIQ 57-76)], a prevalência de FA foi 25,3%, com incidência de 5,64 casos/100 pessoas-ano. 221 Entre os pacientes com doença cardiovascular que procuraram o setor de emergência, a prevalência de FA foi 40% daqueles com insuficiência cardíaca descompensada 222 e 44% daqueles com doença valvar cardíaca. 187 …”

“…220 In another study of 186 patients with pacemakers from a single center in Southern Brazil [52% women; median age, 67 years (IQR 57-76)], the prevalence of AF was 25.3%, with an incidence of 5.64 cases/100 persons-year. 221 Among patients with cardiovascular disease visiting the emergency department, the prevalence of AF was 40% of those with decompensated heart failure 222 and 44% of those with valvular heart disease. 187 …”