Pacemaker-detected atrial fibrillation burden and risk of ischemic stroke or thromboembolic events-A cohort study

Heart & Lung : the Journal of Critical Care
Song-Yun ChuYan-Sheng Ding

Abstract

Atrial fibrillation (AF) burden might link to increased risk of systemic embolism. Current scoring systems for evaluating stroke risks such as CHA2DS2-VASc do not incorporate AF burden partly because of the difficulty to assess these data. Patients with dual-chamber pacemakers implanted have opportunities to acquire incidence and duration of AF. We aimed to evaluate the AF burden and its association with thromboembolism in patients with dual-chamber pacemakers. This retrospective cohort study enrolled patients who underwent dual-chamber pacemaker implantation at our center between October 2003 and May 2017. We excluded patients with prior thromboembolism or receiving anticoagulants. The incidence and duration of pacemaker-detected AF were compared between patients with and without thromboembolic outcomes. Propensity score matching (1:1) was conducted based on clinical characteristics. Multivariate regressions were performed to determine the predictors of thromboembolic outcomes. Survival free from stroke and thromboembolism was assessed using Kaplan-Meier analysis in groups with different AF burden. Among the 152 patients enrolled (43.4% women; age 73.2 ± 13.3 years), ten experienced thromboembolic events within a median follow...Continue Reading

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