Effect Of Atrial Pacing Ratio On Postoperative Atrial Fibrillation In Patients With SSS

Objective: To retrospectively analyze the occurrence of atrial fibrillation after implantation of a dual-chamber pacemaker in patients with morbid sinus node syndrome without atrial fibrillation before surgery,and to explore the right atrial pacing ratio(cumulative pacing percentage Cumm% AP)The effects of postoperative atrial fibrillation and other risk factors that may affect the occurrence of atrial fibrillation were analyzed to provide guidance for the application of pacemakers in the clinic.Methods: Review the program-controlled data of patients with first-time dual-chamber pacemaker implantation due to morbid sinus node syndrome(SSS)and no atrial fibrillation in the first affiliated Rocky Mountain of Wannan Medical College from June2017 to December 2019.analysis.The pacemaker was programmed for 3 months,6months,12 months,and once a year thereafter.The follow-up content includes: right atrial pacing ratio(Cum% AP),right ventricular pacing ratio(Cum% VP),new onset of atrial fibrillation and the number and duration of atrial fibrillation,the presence of other new diseases and cardiovascular death Events,etc.,and collected the patient's age,gender,combined underlying diseases,medications taken,number of hospitalizations due to heart failure,number of mode conversions,and left atrial diameter,left ventricular diameter,and left ventricular ejection fraction.According to the atrial pacing ratio,the right atrial pacing ratio was <40%(low atrial pacing ratio group),and the cumulative right atrial pacing ratio was? 40%(high atrial pacing ratio group).Data conforming to the normal distribution are expressed as mean ± standard deviation,and comparison between groups was performed using independent sample t test.Categoricaldata is expressed by n(%),and comparison between groups is performed using 2 or Fisher exact test.Multivariate analysis of atrial fibrillation was tested using a binary logistic regression model.The test direction is two-sided.P <0.05 considers the difference to be statistically significant.The statistical process is based on SPSS 25.0.Results:In the 80 patients enrolled,within a mean follow-up of 16.61 ± 6.98 months,38 cases of new AF occurred(47.5%),of which 42 cases of high atrial pacing group(Cum% AP?40%)had new AF.There were 23 patients(39.5%)and 38 patients with low atrial pacing(Cum% AP <40%).The average age of the patients was(63.63 ± 8.71)years old.There were 32 males and 48 females,26 with diabetes,42 with hypertension,29 with coronary heart disease,and 44 with enlarged left atrium.The number of patients hospitalized for heart failure was 8 cases.Logistic regression analysis showed that the atrial pacing ratio was ?40%(OR = 0.221,95% CI 0.07-0.67,P = 0.008),making atrial fibrillation difficult,and hypertension(OR = 3.786,95% CI 1.328-10.794,P = 0.013),Left atrial enlargement(OR = 3.989,95% CI 1.309-12.162,P = 0.013)is an independent risk factor for tremor.Conclusion: 1.With the increase of atrial pacing ratio,AF is less likely to occur.A high atrial pacing ratio is an independent protective factor for the occurrence of atrial fibrillation.Hypertension and increased left atrial diameter contribute to the occurrence of AF and are independent risk factors for AF.2.Age,gender,coronary heart disease,diabetes,left ventricular ejection fraction(LVEF%),postoperative left ventricular end diastolic diameter,number of hospitalizations due to heart failure,and medication are not related to new AF.