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Erschienen in: Heart and Vessels 9/2023

07.04.2023 | Original Article

Progression from paroxysmal to persistent atrial fibrillation in pacemaker patients with tachycardia–bradycardia syndrome: a multicenter study

verfasst von: Naoto Oguri, Akinori Sairaku, Nobuyuki Morishima, Yasuhiko Hayashi, Yuji Muraoka, Shunsuke Tomomori, Takenori Okada, Yukiko Nakano

Erschienen in: Heart and Vessels | Ausgabe 9/2023

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Abstract

Progression from paroxysmal to persistent atrial fibrillation (AF) is occasionally encountered in patients with previous pacemaker implantation (PMI) for the treatment of tachycardia–bradycardia syndrome (TBS). We aimed to determine the rate of its incidence occurring within the early years after PMI and the predictors. We studied TBS patients who received PMI at 5 core cardiovascular centers. The end point was a conversion from paroxysmal to persistent AF. We extracted 342 TBS patients out of 2579 undergoing PMI. During 5 ± 3.1 years of follow-up, 114 (33.3%) reached the end point. The time to the end point was 2.9 ± 2.7 years. The event rates within a year and 3 years after the PMI were 8.8% and 19.6%, respectively. In the multivariate hazard analyses, hypertension (hazard ratio [HR] 3.2, P = 0.03) and congestive heart failure (HR 2.1, P = 0.04) were found to be independent predictors of the end point occurring within a year after the PMI. Congestive heart failure (HR 1.82, P = 0.04), left atrial diameter of ≥ 40 mm (HR 4.55, P < 0.001), and the use of antiarrhythmic agents (HR 0.58, P = 0.04) were independently associated with the 3-year end point. Prediction models including combinations of those 4 parameters for the 1- and 3-year incidence both exhibited a modest risk discrimination (both c-statistics 0.71). In conclusion, early progression from paroxysmal to persistent AF was less frequent than expected in the TBS patients with PMI. Factors related to atrial remodeling and no use of antiarrhythmic drugs may facilitate the progression.
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Metadaten
Titel
Progression from paroxysmal to persistent atrial fibrillation in pacemaker patients with tachycardia–bradycardia syndrome: a multicenter study
verfasst von
Naoto Oguri
Akinori Sairaku
Nobuyuki Morishima
Yasuhiko Hayashi
Yuji Muraoka
Shunsuke Tomomori
Takenori Okada
Yukiko Nakano
Publikationsdatum
07.04.2023
Verlag
Springer Japan
Erschienen in
Heart and Vessels / Ausgabe 9/2023
Print ISSN: 0910-8327
Elektronische ISSN: 1615-2573
DOI
https://doi.org/10.1007/s00380-023-02266-5

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