Clinical, Echocardiographic, and Electrocardiographic Predictors of Persistent Atrial Fibrillation after Dual-Chamber Pacemaker Implantation: An Integrated Scoring Model ApproachReportar como inadecuado




Clinical, Echocardiographic, and Electrocardiographic Predictors of Persistent Atrial Fibrillation after Dual-Chamber Pacemaker Implantation: An Integrated Scoring Model Approach - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Persistent atrial fibrillation PeAF predictors after dual-chamber pacemaker PM implantation remain unclear. We sought to determine these predictors and establish an integrated scoring model. Data were retrospectively reviewed for 649 patients 63.8 ± 12.3 years, 48.6% male, mean CHA2DS2–VASC score 2.7 ± 2.0 undergoing dual-chamber PM implantation. PeAF was defined as documented AF on two consecutive electrocardiograms acquired ≥7 days apart. During a 7.1-year median follow-up interquartile range 4.5–10.1 years, 67 10.3% patients had PeAF. Multivariable analysis showed the following independent predictors of future PeAF: ischemic stroke or transient ischemic accident history hazard ratio HR 2.03, 95% confidence interval CI 1.03–3.50, p = 0.040, atrial fibrillation-flutter history HR 1.80, 95% CI 1.01–3.20, p = 0.046, sinus node disease HR 2.24, 95% CI 1.16–4.35, p = 0.016, left atrial enlargement >45 mm, HR 2.14, 95% CI 1.26–3.63, p = 0.005, and time in automatic mode switching >1% at first follow-up interrogation HR 2.58, 95% CI 1.51–4.42, p < 0.001. An integrated scoring model combining these predictors showed good discrimination performance at the seven-year follow-up. C-statistic 0.716, 95% CI 0.629–0.802, p < 0.001. Significantly greater seven-year PeAF incidences were seen in patients with higher scores 2–5 than in those with lower scores 0–1 22.8% ± 3.8% vs. 5.3% ± 1.7%, p < 0.001. In conclusion, an integrated scoring model combining clinical, echocardiographic, and electrocardiographic characteristics is useful for predicting future PeAF in patients with a dual-chamber PM.



Autor: Min Soo Cho, Jun Kim , Ju Hyeon Kim, Minsu Kim, Ji Hyun Lee, You Mi Hwang, Uk Jo, Gi-Byoung Nam, Kee-Joon Choi, You-Ho Kim

Fuente: http://plos.srce.hr/



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