Incidence Of New Atrial Fibrillation In Patients After Dual-Chamber Pacemaker Implantation

Objective: To analyze the occurrence of new atrial fibrillation(AF)and its related influencing factors in patients after dual-chamber pacemaker implantation,provide the basis to ruduce its incidence.Method:Eighty five patients were selected from March 2014 to October 2017 in our department who have sick sinus syndrome(SSS)or atrioventricular block(AVB)with no AF history implanted with a dual-chamber pacemaker first time.Among them,36 patients with SSS,41 patients with AVB,and 8 patients have both SSS and AVB.After(386.73 + 285.73)d follow up,the occurrence of new AF in patients was observed.The percentages of four pacing and sense status including atrial sense-ventricular sense(AS-VS),atrial sense-ventricular pacing(AS-VP),atrial pacing-ventricular sense(AP-VS)and pacing-ventricular pacing(AP-VP),percentages of atrial pacing(AP%),percentages of ventricular pacing(VP%),heart ultrasound results and clinical data were analyzed and compared to evaluate the postoperative effect with AF.Results: The incidence rate of patients with AF was 22.35%.New AF was found related to gender,AP-VP,the left atrial diameter and left ventricular diameter(P<0.05).Irrelevant to age,basic diseases,implantation of indications,hepatic and renal dysfunction,AS-VS mode,AS-VP mode,AP-VS mode,AP%,VP%,left ventricular ejection fraction(P>0.05).Multivariate logistic regression analysis indicated that AP-VP mode(OR 1.038 95%CI:1.005-1.071 P=0.022),left atrial diameter(OR 1.038 95%CI:1.005-1.071 P=0.022)were the independent risk factors for new AF after dual-chamber pacemaker implantation.The new AF incidence was linearly correlated with left atrial diameter,each millimeter left atrial diameter grew,a 1.38% AF was increased.Patients treated with Calcium channel blocker(CCB)had a lower incidence of AF(OR 0.102 95%CI:0.021-0.500 P=0.005).Conclusions:A higher AF incidence occurred after dual-chamber pacemaker implantation.AP-VP mode and left atrial dilation were the independent risk factors for new AF after the dual-chamber pacemaker implantation.Patients taken with CCB can reduce the occurrence of AF.