Analysis On The Risk Factors Of Atrial Fibrillation After Pacemaker Implantation And The Correlation Between Atrial Fibrillation And Atrial Natriuretic Peptide

ObjectiveWith the application of a pacemaker, the complications occurred. Some patients with cardiac pacing pacemaker had new onset atrial fibrillation(AF),which had a serious impact on long-term survival of patients and quality of life. This study will analyze incidence of new-onset atrial fibrillation of patients with dual chamber pacemaker implantation, risk factors of AF and the correlations of plasma ANP and atrial fibrillation. To provide theoretical and practical basis for the options of pacemaker and pacing and clinical interventions.Material and MethodsResearch object for February 2010 to February 2013, 57 cases of sick sinus syndrome(SSS)(n = 30) and atrioventricular block(AVB)(n = 27) with implanted double chamber pacemaker, and the preoperative diagnosis for patients without atrial fibrillation, for each patient postoperative 1 month, 3 months, 6 months, and 12 months after a follow-up pacemaker SPC. When a follow-up determine the date of the attack,attack frequency and duration of each atrial high-rate episode(AHRE). At the same time the percentage of atrial and ventricular pacing were recorded. Using SPSS13.0 statistical analysis, measurement data with mean±standard deviation, count data is expressed as percentage. Single factor measurement data using t test, the comparison of variables between groups with chi-square test. Using multi-factor stepwise Logistic regression analysis of the correlation of atrial fibrillation and basic data, clinical history, pacemaker,ANP. P < 0.05 that was statistically significant.ResultsGrouped by indication of implantation, the patients of permanent pacemaker implantation for SSS or AVB have no statistical difference in age, sex, basic diseases(such as hypertension, diabetes, coronary heart disease, and congestive heart failure), LAV, LVEF and previous drug history. The incidence of atrial fibrillation for follow-up cases is 26.3%, the incidence of atrial fibrillation for SSS group is 30%, for AVB group is 22.2%.With a follow-up of 12 months in average, AHRE attacks relatively frequently among 3 months to 12 months after implantation.In patients with atrioventricular block or sick sinus syndrome, the cumulative percentage of atrial pacing and the cumulative percentage of ventricular pacing have no significant difference between patients with atrial fibrillation and patients without atrial fibrillation.By comparing the patients with atrial fibrillation and without atrial fibrillation after pacemaker implantation, we find that age of the patients with atrial fibrillation is significantly higher than the patients without atrial fibrillation(P<0.05); left atrial volume of the patients with atrial fibrillation is significantly bigger than the patients without atrial fibrillation(P<0.05); ANP concentrations of atrial fibrillation group is obviously higher than that without atrial fibrillation group(P < 0.05).Multivariable Logistic regression analysis finds that the attacks of new atrial fibrillation are significantly associated with age, congestive heart failure, larger LAV, high concentration of ANP. Conclusion1. The incidence of atrial fibrillation after a pacemaker implantation is relatively high, and the primary indications has no obvious effect on the postoperative incidence of atrial fibrillation.2. Continuous monitoring function of the pacemaker can find an occult AHRE attack early,The incidence of AHRE increased with time.3. Either patients of AVB or SSS,the incidence of atrial fibrillation had no significant difference among pacing mode.4. The incidence of atrial fibrillation after a pacemaker implantation may be related to age, congestive heart failure, enlargement of LAV and concentration of ANP.