Journal of Electrocardiology
Volume 42, Issue 2 , Pages 128-135, March 2009

Influence of structural heart disease on characteristics of atrial fibrillation recurrence in patients with dual-chamber pacemakers☆

  • Michael J. Reiter, MD, PhD

      Affiliations

    • Department of Medicine, University of Colorado Health Sciences Center, Denver, CO, USA
    • Corresponding Author InformationCorresponding author. 5083 Oak Hollow Drive, Morrison, CO 80465, USA. Tel.: +1 303 697 6339.
    • ,
  • Manya Harsch, MS

      Affiliations

    • Vitatron Clinical Research, Minneapolis, MN, USA
    • ,
  • Te-Hsin Lung, PhD

      Affiliations

    • Vitatron Clinical Research, Minneapolis, MN, USA
    • ,
  • Dave Munneke, MS

      Affiliations

    • Vitatron Clinical Research, Minneapolis, MN, USA
    • ,
  • Michael H. Kim, MD, FACC

      Affiliations

    • Department of Medicine, Northwestern University, Feinberg School of Medicine Chicago, IL, USA
    • ,
  • Alaa Shalaby, MD, FACC

      Affiliations

    • Department of Medicine, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
    • ,
  • for the Vitatron AFm Registry Investigators

Received 26 November 2007 published online 03 November 2008.

Abstract 

Aims

The aim of the study was to prospectively examine the influence of structural heart disease (SHD) and sinus node dysfunction (SND) on the frequency and duration of atrial fibrillation (AF) episodes in patients with implanted pacemakers.

Methods

We examined episodes of AF in 207 patients (93 with SHD; 165 with SND) with known or suspected paroxysmal AF who underwent dual-chamber pacing.

Results

Seventy-one percent of all patients experienced at least one episode of AF during follow-up, with a mean burden of 3.3 ± 6.4 h/d (median, 0.2 hours) and a mean frequency of 11.7 ± 26.0 episodes per day (median, 1.4). The proportion of episodes longer than 6 hours was greater in patients with SHD when compared to patients without SHD. In a logistic regression model adjusted for SND, gender, and the 2-way interactions of SND, sex, and SHD, SHD was a significant factor (P = .0188) with the odds ratio of having an episode longer than 6 hours 3.4 times higher for patients with SHD than for patients without SHD. Older patients with SHD had less frequent but longer episodes compared to younger patients. In patients without SHD, there was no comparable age difference. Burden, frequency, and average episode length were not influenced by the presence or absence of SND.

Conclusions

Patients with SHD have longer episodes of AF supporting the concept that SHD influences the underlying substrate to favor perpetuation.

Keywords: Atrial fibrillation, Structural heart disease, Epidemiology, Cardiac pacing

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☆ This study was supported by Vitatron Clinical Research, Minneapolis, MN. Manya Harsch, Te-Hsin Lung, and Dave Munneke are employees of Medtronic (Minneapolis, MN, USA).

PII: S0022-0736(08)00353-1

doi:10.1016/j.jelectrocard.2008.09.002

Journal of Electrocardiology
Volume 42, Issue 2 , Pages 128-135, March 2009

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