Analyses of risk factors and prognosis for new-onset atrial fibrillation in elderly patients after dual-chamber pacemaker implantation

Xiao-Li CHEN; Xue-Jun REN; Zhuo LIANG; Zhi-Hong HAN; Tao ZHANG; Zhi LUO

doi:10.11909/j.issn.1671-5411.2018.10.008

摘要：Objective To retrospectively identify risk factors and the prognosis for new-onset atrial fibrillation (AF) after implantation of dual-chamber pacemakers in elderly patients.Methods Consecutive patients aged ＞ 65 years who underwent their first implantation of a dual-chamber permanent pacemaker in Beijing Anzhen Hospital from October 2013 to May 2016 were enrolled.Their complete programming and follow-up data were recorded.Follow-up end points included new-onset AF and major adverse cardiovascular and cerebrovascular events.Results Altogether,322 patients were enrolled,with new-onset AF observed in 79 (24.5％) during their follow-up.Multivariable analysis identified four independent predictors of new-onset AF in elderly patients after pacemaker implantation:hypertension (HR =3.040,95％ CI:1.09-3.05,P =0.00);age (HR =1.966,95％ CI:1.57-3.68,P =0.01);left atrial enlargement (HR =1.645,95％ CI:1.05-1.25,P =0.03);high ventricular pacing rate (HR =1.137,95％ CI:1.01-1.06,P =0.01).Univariable analysis indicated that the CHA2DS2-VASc score was also a risk factor for AF (HR =1.368,95％ CI:1.178-1.589,P =0.002),whereas multivariable regression analysis did not.Kaplan-Meier survival analysis showed that the risk for ischemic stroke was significantly higher in the new-onset AF group than in the non-AF group (P ＜ 0.05).Conclusion Hypertension,age,left atrial enlargement,and high ventricular pacing rate were independent predictors of new-onset AF in elderly patients after implantation of a permanent pacemaker.New-onset AF increased the risk for ischemic stroke.