Analysis Of The Incidence Of Atrial Arrhythmia And The Related Factors After Implantation Of Double Chamber Pacemaker

Aims:Atrial fibrillation is a common complication of pacemaker implantation. The pacing mode on the incidence of atrial fibrillation and related mechanism have become an increasing concern. Through the long-term follow-up of implantation of dual chamber pacemaker patients, to observe the prevalence of atrial fibrillation and possible factors related to the occurrence of atrial fibrillation.Methods:Between 2013 January to 2014 December, consecutively selected patients with dual chamber pacemakers followed up in Cardiac Pacemaker Clinic of Affiliated Drum Tower Hospital, Nanjing University. Retrospectively collect the basic information before the operation, pacemaker follow-up program report and medical record. Read the pacemaker recorded data, including the percentage of atrial and ventricular pacing, and atrial fibrillation burden.Results:A total follow-up of 197 patients implanted with dual chamber pacemaker, included 106 patients with sick sinus syndrome and 91 patients with atrioventricular block. The mean follow-up was 35.96+12.95 months. The incidence of AF increased with times, reaching 40% at 48 months. The incidence of AF increased faster in the SSS group with 55% at 48 months, compared with atrioventricular block group with 36%. The onset of atrial fibrillation was earlier and the atrial fibrillation burden was heavier in SSS group. There were significant differences between the two group(p<0.01). Pearson correlation analysis and logistic multivariate model both show that there were no relationship between atrial fibrillation and AP, VP, LVEF, sex, age. Analyse the occurrence of atrial fibrillation among different atrial pacing percentage. Atrial pacing percentage in SSS group were divided into 3 groups, AP<30%, AP 30%-70%, AP>70%, we finding a trend that the higher the proportion of atrial pacing, the lower the frequency of atrial fibrillation.. The AF burden in the group of AP>70% was 10.65±6.10%, significantly lower than the average value.Conclusions:The incidence of atrial fibrillation increased over time after implantation of pacemakers. The onset of atrial fibrillation was earlier and the atrial fibrillation burden was heavier in SSS group compared with atrioventricular block group. Pearson correlation analysis and logistic multivariate model both show that there were no relationship between atrial fibrillation and AP, VP, LVEF, sex, age. However, we find a phenomenon that the higher the proportion of atrial pacing, the lower the frequency of atrial fibrillation. But, atrial pacing proportion had no significant difference on paroxysmal atrial fibrillation starting time.