Analysis Of Incidence Of Atrial Fibrillation And Related Factors In Elderly Patients After Double Chamber Pacemaker Implantation

Objective: To investigate the occurrence of atrial fibrillation and related factors in elderly patients after dual-chamber pacemaker implantation.Methods: from January 2008 to December 2016,150 cases of DDD dual chamber pacemaker were implanted in the Department of Cardiology,the First Affiliated Hospital of Hebei North University,and they agreed to receive program-controlled elderly patients regularly.The pacemaker atrial electrode was located in the right auricle,and the ventricular electrode was located in the tip of the right ventricle,Five dead patients were excluded,9 lost patients were excluded,and 136 cases were selected.The patients were followed up for 3 years after pacemaker implantation.The baseline characteristics,echocardiographic parameters,pacemaker parameters during the follow-up period and the occurrence of atrial fibrillation were recorded.The patients were divided into AF group and non-AF group according to the occurrence of atrial fibrillation.The risk factors of atrial fibrillation after pacemaker implantation were analyzed.Results: A total of 136 patients were enrolled.Among the selected patients,73 were males and 63 were females,56 were sick sinus syndrome(SSS),and 76 were atrioventricular block(AVB).4 patients had SSS and AVB,56 had hypertension before operation,and 43 had diabetes before operation.The mean follow-up time was(30.5±10.6)months.A total of 44 cases(32.3%)of atrial fibrillation within 3 years of the selected cases were set as the AF group,and the remaining 92 cases without AF were set as the non-AF group.The clinical data of the two groups of patients were compared.The average age of patients with AF was greater than that of non-AF patients(74.1±5.1 vs 72.0±5.5,P =0.042).Among the patients with AF,there were more men with hypertension and basic hypertension than non-AF patients.Compared with the non-AF groups,left ventricular ejection fraction(LVEF)decreased,the left atrial diameter(LVEDD)increased,the left atrium diameter(LAD)increased significantly.The rate of ventricular pacing in patients with SSS was higher than that in the non-AF group.Logistic regression analysis revealed that male(B=0.976,OR=2.654,95%CI:1.098～6.4012,P=0.030),hypertension(B=0.909,OR=2.483,95%CI:0.176～5.730,P=0.045),and LAD increased(B=0.135,OR=1.145,95%CI:1.036～1.265,P=0.008)correlated with newonset AF after implantation of dual-chamber pacemaker in elderly patients.Conclusion: Age,male,left atrial diameter,history of hypertension were related to the occurrence of atrial fibrillation in elderly patients after dual chamber pacing implantation.Among them,male,LAD increase and hypertension history are risk factors of atrial fibrillation in elderly patients after implantation of dual chamber pacemaker.LVEDD,LVEF,proportion of ventricular pacing and proportion of atrial pacing were not related to the occurrence of atrial fibrillation.The proportion of ventricular pacing in elderly patients with SSS may be related to postoperative atrial fibrillation.