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Development of Atrial Fibrillation in Patients with Atrioventricular Block After Atrioventricular Synchronized Pacing
Author(s) -
KONG CHIWOON,
TUAN TACHUAN,
YIN WEIHSIAN,
YU WENCHUNG,
CHEN SHIHANN,
LIN YENNJIANG,
HUANG CHUNYAO,
CHUNG SHENGLIANG
Publication year - 2004
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.2004.00440.x
Subject(s) - medicine , atrial fibrillation , atrioventricular block , incidence (geometry) , bradycardia , cardiology , heart block , premature atrial contraction , electrocardiography , heart rate , physics , blood pressure , optics
Many studies have evidenced an increased incidence of AF in patients receiving single chamber ventricular pacing (VVI) when compared with those undergoing an atrial‐based system (AAI or DDD). However, the difference in incidence of AF between two atrial‐based systems (VDD, DDD) in patients with AV block was still controversial. This study was conducted to compare the development of AF between different modes of pacemakers (VDD and DDD) in patients with symptomatic AV block. A retrospective review was conducted of the detailed records of all consecutive patients who received permanent pacemakers due to symptomatic bradycardia from March 1995 to March 2000. The occurrence of AF was documented when there was presence of AF in the free‐run or 12‐lead ECG, any ECG strips, or persistent AF on 24‐hour Holter ECG during the follow‐up. The study included 152 patients (44 women, 108 men; mean age 73). The patients were divided into two groups: VDD (n = 100) and DDD (n = 52). The mean follow‐up was 48.9 ± 22.9 months. The incidence of AF was 7.9%. A higher incidence of AF was noted in the DDD group (15.4%) when compared with the VDD group (4.0%, P = 0.023). The incidence of development of AF in patients with AV block was higher in those receiving DDD cardiac pacing when compared with those who received the VDD system. The authors suggest that VDD pacing may be a better choice than the DDD system for patients with AV block, but without clinical evidence of sinus node dysfunction, and if an atrial lead is required, it should be placed close to the Bachmann's bundle. (PACE 2004; 27:352–357)