Follow-up Analysis Of The Effect Of Right Ventricular Pacing On New Onset Atrial Fibrillation After Pacemaker Implantation

Objective: To Retrospectively analysis the relationship between the ratio of right ventricular pacing(Cum%VP)and the incidence of new onset atrial fibrillation(AF)after double chamber pacemaker implantation,and to analyze the risk factors for the occurrence of atrial fibrillation(AF).Methods: A retrospective analysis of the follow-up data of patients without atrial fibrillation before implantation of dual chamber pacemaker in our hospital from 2010 to 2014 due to atrioventricular block(AVB)or sick sinus syndrome(SSS)over II degrees was performed.This study enrolled 109 patients,69 of them are SSS patients,and 40 of them are AVB patients.The patients were followed up at 3,6,12 months and every year after surgery.Fllow up included right atrial pacing(Cum%AP),right ventricular pacing(Cum%VP),new onset atrial fibrillation,cardiovascular events,death,and stroke.Patients were divided into tow groups by the ratio of right ventricular pacing,the group Cum%VP<50% has 46 cases and the group Cum%VP?50%.We analyzed the clinical characteristics of the two groups,used Kaplan-meier method to draw the time curve of atrial fibrillation in two groups,and used COX proportional hazardsmodel to do Multivariate correlation analysis.Results: With the prolongation of time,the incidence of new onset atrial fibrillation in patients with dual chamber pacemaker implantation increased.72 of the 109 patients occured new onset atrial fibrillation for a median45.81±15.97 months.52 of the 72 were in group Cum%VP ?50%,and the others were in group Cum%VP<50%.The Kaplan-meier time curve showed that the risk of new onset atrial fibrillation in the the high right ventricular pacing ratio group(Cum%VP = 50%)is higher than the low percentage of right ventricular pacing group(Cum%VP < 50%)(P=0.01,log-Rank),the difference was statistically significant.Multivariate COX analysis showed that the radio of the right ventricular pacing was an independent risk factor for new onset atrial fibrillation(HR1.010;95%CI:1.004-1.016;P=0.001)after pacemaker implantation.Conclusion: The high proportion of long-term right ventricular pacing was an independent risk factor for new onset atrial fibrillation after pacemaker implantation.Furthermore,preoperative left ventricular diastolic diameter,left atrial diameter,left ventricular ejection fraction(EF%),underlying diseases were independent of the new onset atrial fibrillation after operation.