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Duration of P‐Wave Is Associated with Atrial Fibrillation Hospitalizations in Patients with Atrial Fibrillation and Paced for Bradycardia
Author(s) -
PADELETTI LUIGI,
SANTINI MASSIMO,
BORIANI GIUSEPPE,
BOTTO GIANLUCA,
RICCI RENATO,
SPAMPINATO ANDREA,
VERGARA GIUSEPPE,
RAHUE WERNER G,
CAPUCCI ALESSANDRO,
GULIZIA MICHELE,
PIERAGNOLI PAOLO,
GRAMMATICO ANDREA,
PLATONOV PYOTR,
BAROLD S. SERGE
Publication year - 2007
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.1540-8159.2007.00793.x
Subject(s) - medicine , atrial fibrillation , bradycardia , cardiology , confidence interval , cardioversion , quartile , prospective cohort study , interquartile range , heart rate , blood pressure
Background: Atrial fibrillation (AF) is a common problem in pacemaker patients. We conducted a prospective observational study in patients paced for bradycardia with associated paroxysmal or persistent AF, to determine whether P‐wave duration may stratify patients at higher risk for AF recurrences and AF‐related hospitalizations. The patients were evaluated for the prevalence, cause, and predictors of hospitalization.Methods: We studied 660 consecutive patients (50% male, 72 ± 9 years) who received a dual‐chamber pacemaker. Median value of baseline P‐wave duration was equal to 100 ms (25%–75% quartile range equal to 80–120 ms). We used this cut‐off to divide the patients into group A (P ≤ 100 ms), composed of 385 (58.3%) patients, and group B (P>100 ms), composed of 275 (41.7%) patients.Results: In a median follow‐up of 19 months, 173 patients were hospitalized for all causes, 130 for cardiovascular causes, and 85 for AF‐related hospitalizations. Multivariate logistic analysis showed that P‐wave duration >100 ms identified patients at higher risk (OR = 1.6, 95% confidence interval (1.1–2.8), P = 0.044) for AF‐related hospitalizations. Patients in group B (P > 100 ms) more frequently suffered AF‐related hospitalizations (16.4% vs 10.4%, P = 0.02) and underwent more frequent cardioversions (14.5% vs 9.1%, P = 0.029) compared with group A (P ≤ 100 ms).Conclusions: P‐wave duration may define the risk of persistent AF requiring cardioversion or AF‐related hospitalization in patients with a pacemaker for bradycardia with associated paroxysmal or persistent AF.