Analyses Of Risk Factors Of Newly Detected Atrial Fibrillation In Patients With Sick Sinus Syndrome Or Atrioventricular Block After Dual-chamber Pacemaker Implantation

Objective: to analyze the newly detected atrial fibrillation(AF)in patients with sick sinus node syndrome(SSS)or atrioventricular block(AVB)after implantation of dual-chamber pacemaker and to analyze the related influencing factors of atrial fibrillation after pacemaker implantation.Methods: from January 2012 to December 2014,a total of 146 cases were selected with dual-chamber pacemaker implanted for the first time in the department of Cardiology of of the first affiliated hospital of Hebei North University.The patients were divided into 58 cases of sick sinus syndrome and 88 cases of atrioventricular block.The basic condition of the patients(age,sex,history of hypentension,history of diabetes)was recorded and the results of UCG were recorded(left atrial diameter,left ventricular diameter,left ventricular ejection fraction)before the operation.Pacemaker parameters were collected during operation(the pacing perception,threshold,impedance of atrial and ventricular).The postoperative follow-up period was 36 months.The patients were followed up at 1,3,6,12,24,and 36 months after the operation.We record relevant data during pacemaker program(atrial pacemaker ratio,ventricular pacing ratio,whether the AF occurs).Comparing the difference of newiy detected AF after pacemaker operation between the two groups,and analyze the factors affecting the happening of AF after pacemaker operation.Results: Among the 146 patients with pacemaker implantation,there were 38 patients were detected with atrial fibrillation,during the follow-up period.The incidence of AF was 26.0%.Univariate Logistic regression analysis of 146 patients showed that age,causes,hypertension,diabetes,VP% and left atrial diameter had a significant effect on the new atrial fibrillation after pacemaker implantation(P<0.05).Multivariate Logistic regression analysis showed that age,hypertensive left,atrial diameter was independent risk factor for new atrial fibrillation after pacemaker operation(P<0.05).According to the cause of pacemaker implantation,the patients were divided into 58 cases in the SSS group and 88 cases in the AVB group.Among the 58 patients in the sick sinus group,21 had atrial fibrillation,and the incidence of atrial fibrillation was 36.2%.Among the 88 patients in the atrioventricular block group,17 had atrial fibrillation,and the incidence of atrial fibrillation was 19.3%.Compared with patients with atrioventricular block,the incidence of AF after pacemaker implantation was higher in patients with SSS,and the difference was statistically significant(P=0.02,P<0.05).The basic data of two groups of patients,the result of UCG and the pacemaker parameters were compared.It was found that the patients with SSS,the prevalence of diabetes was obviously higher than that with AVB(P = 0.02),left atrial diameter significantly greater than block group(P = 0.04),atrial pacing is notably higher than that with AVB group(P = 0.00),ventricular pacing rate was lower than that in AVB group(P = 0.00).the factors such as age,hypertension prevalence,left interior diameter,LVEF,atrial pacing threshold,atrial sensing,atrial impedance,ventricular pacing threshold and perception were no statistically significant difference in ventricular impedance(P>0.05).Conclusion: 1.Age,left atrial diameter and hypertension has predictive value to newly detected atrial fibrillation after pacemaker operation.2.Compared with patients with atrioventricular block,patients with sick sinus node syndrome have higher incidence of atrial fibrillation.The factors such as dysfunction of the sinoatrial node,diabetes,high atrial pacing ratio and large left atrial diameter may be influencing factors for the high incidence of atrial fibrillation.