A Retrospective Study Of Atrial Fibrillation After DDD Pacemaker Implantation

Objective:Past research is mostly a single factor comparison analysis aimed at certain indicators after pacemaker implantation, this study investigate the incidence of atrial fibrillation(AF) and the influence factors in patients following pacemaker implantation, in order to make clear its relevance, and to provide basis for treatment and associated with late.Methods: The object of this reaserch is 122 patients with SSS who was implanted pacemaker from 2012 to 2014, each patient follow-up on the first month,the third months and the sixth months after the operation,and once every six months after the first.Content of the follow-up include patients’ general symptoms,such as heart palpitations,chest pain,shortness of breath,dizziness et al.Determination of atrial high-rate episode(AHRE) date,seizure frequency, duration.Recording of the atrial and ventricular pacing percentage(Cum%AP and Cum%VP).Deal those dates with SPSS17.0 statistical software, measurement data to the mean±standard deviation, count data is expressed as a percentage.Single factor measurement data using t test, multiple factors analysis using logistic regression analysis,P < 0.05 was considered statistically significant.Results:After 16.41±6.69 months follow-up, 61 cases(51.64%)were detected AF after pacemaker implantation.The percentage of newly detected AF is 32.5%.There are 14.29% patients were detected asymptomatic atrial fibrillation.Of these 122 patients, the atrial pacing percentage(OR=1.587,95%CI 0.863-2.395,P=0.001),the ventricular pacing percentage(OR=1.782,95%CI:1.063-2.867,P=0.001),preoperative history of paroxysmal atrial fibrillation(OR=2.879,95%CI:1.222-3.782,P=0.001)were the significant predictors of atrial fibrillation after pacemaker implantation.The other factors,such as age, with or without diabetes, hypertension, coronary heart disease, and the left atrial diameter, left interior diameter, EF,were not associated with the occurrence rate of AF.Analyse the fators of the 63 patients who has AF after pacemaker implantation. Patients with asymptomatic atrial fibrillation were older than the others(72.12±5.43 vs 63.44±6.45 old years, P<0.05).Conclusions:1. For the monitoring of atrial fibrillation, conventional methods, such as electrocardiogram and Holter,may not be reliable.The continuous monitoring function of pacemaker can found the episodes of atrial fibrillation which difficult to find in conventional monitoring methods. 2. Occurrence rate of atrial fibrillation in patients with SSS were high after pacemaker implantation.The atrial pacing percentage,the ventricular pacing percentage and preoperative history of paroxysmal atrial fibrillation were the significant predictors of atrial fibrillation after pacemaker implantation. 3. There are quite a part of the patients who has asymptomatic atrial fibrillation. Advanced age may be associated with increase in asymptomatic atrial fibrillation.