PMID: 9633069Jun 20, 1998Paper

Atrial fibrillation and anticoagulation in patients with permanent pacemakers: implications for stroke prevention

Pacing and Clinical Electrophysiology : PACE
P B SparksL E Grigg

Abstract

Several large prospective randomized trials have demonstrated that anticoagulation with warfarin reduces the risk of thromboembolic stroke in high risk patients with chronic AF by approximately 70%. Large numbers of patients with permanent pacemakers have AF, and anticoagulation rates in this population have not been described. In a prospective analysis of 110 consecutive patients attending the pacemaker clinic of a large university hospital we assessed the number of patients with AF and the proportion of these patients who were receiving anticoagulation to prevent thromboembolic stroke. Where necessary, temporary pacemaker reprogramming to low ventricular rates was utilized to facilitate the diagnosis of AF. Fifty-three of the 110 patients (48%) were diagnosed with AF, all of whom (100%) had accepted high risk factors for thromboembolic stroke. Only eight of the 53 (15%) had been anticoagulated with warfarin. Thirty-six of the 53 patients (68%) diagnosed with AF had no prior documented diagnosis of chronic AF, and the majority had no symptoms suggesting AF. A single lead II ECG was insufficient in 67 of the 110 patients (61%) to diagnose the underlying atrial rhythm; the remainder required 12-lead ECGs or temporary pacemaker r...Continue Reading

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Citations

Sep 15, 2000·Journal of the American College of Cardiology·A M PatelH I Frumin
Feb 7, 2014·Current Treatment Options in Cardiovascular Medicine·Motaz BaibarsJoseph E Marine
Jan 24, 2015·Journal of the American College of Cardiology·Carol Chen-ScarabelliJonathan L Halperin
Apr 26, 2005·Lancet Neurology·Francesco Corea, Nicola Tambasco
Mar 22, 2000·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·A Lodwick
Jun 2, 2001·Stroke; a Journal of Cerebral Circulation·B J Quilliam, K L Lapane
Jun 21, 2006·Pacing and Clinical Electrophysiology : PACE·Carsten W IsraelUNKNOWN BEATS Study Investigators
Jun 30, 2011·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Sandra CabreraAlfredo Bardají
Dec 25, 2004·European Heart Journal·Luigi PadelettiAndrea Grammatico

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