Monitored atrial fibrillation duration predicts arterial embolic events in patients suffering from bradycardia and atrial fibrillation implanted with antitachycardia pacemakers

Alessandro Capucci, Massimo Santini, Luigi Padeletti, Michele Gulizia, GianLuca Botto, Giuseppe Boriani, Renato Ricci, Stefano Favale, Francesco Zolezzi, Natale Di Belardino, Giulio Molon, Fabrizio Drago, Giovanni Q. Villani, Elena Mazzini, Marco Vimercati, Andrea Grammatico

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Abstract

OBJECTIVES: The aim of our study was to evaluate arterial embolism (AE) occurrence rates and predictors in patients suffering from bradycardia and wearing a pacemaker with antitachycardia pacing therapies. BACKGROUND: Atrial fibrillation (AF) is associated with a high incidence of AE. METHODS: A total of 725 patients (360 men, age 71 ± 11 years) were implanted with a DDDRP pacemaker (Medtronic AT500, Medtronic Inc., Minneapolis, Minnesota). At baseline 225 (31.0%) patients received antiplatelet therapy and 264 (36.4%) patients received anticoagulation agents. RESULTS: Over a median 22-month follow-up (25th to 75th interquartile range 16 to 30 months), AE occurred in 14 (1.9%) patients: 7 patients suffered a nonfatal ischemic stroke (0.6% per year), 4 patients had transient ischemic attack (0.34% per year), and 3 patients had embolic complications. Among baseline patients' characteristics, multivariate logistic analysis showed that embolic events are independently associated to ischemic heart disease (7.0 odds ratio [OR], 95% confidence interval [CI] 2.3 to 21.3, p = 0.001), prior embolic event (7.3 OR, 95% CI 1.2 to 43.9, p = 0.029), diabetes (5.0 OR, 95% CI 1.2 to 15.7, p = 0.032), and hypertension (4.1 OR, 95% CI 1.1 to 15.6, p = 0.036). The risk of embolism, adjusted for known risk factors, was 3.1 times increased (95% CI 1.1 to 10.5, p = 0.044) in patients with device-detected atrial fibrillation episodes longer than one day during follow-up. CONCLUSIONS: In a cohort of patients with bradycardia and AF, arterial embolism was common in patients with ischemic cardiopathy, hypertension, diabetes mellitus, and in patients with known stroke risk factors. Atrial fibrillation occurrences longer than one day were independently associated with embolic events.

Original languageEnglish
Pages (from-to)1913-1920
Number of pages8
JournalJournal of the American College of Cardiology
Volume46
Issue number10
DOIs
Publication statusPublished - Nov 15 2005

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Bradycardia
Atrial Fibrillation
Embolism
Confidence Intervals
Odds Ratio
Stroke
Hypertension
Transient Ischemic Attack
Anticoagulants
Myocardial Ischemia
Diabetes Mellitus
Multivariate Analysis

ASJC Scopus subject areas

  • Nursing(all)

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Monitored atrial fibrillation duration predicts arterial embolic events in patients suffering from bradycardia and atrial fibrillation implanted with antitachycardia pacemakers. / Capucci, Alessandro; Santini, Massimo; Padeletti, Luigi; Gulizia, Michele; Botto, GianLuca; Boriani, Giuseppe; Ricci, Renato; Favale, Stefano; Zolezzi, Francesco; Di Belardino, Natale; Molon, Giulio; Drago, Fabrizio; Villani, Giovanni Q.; Mazzini, Elena; Vimercati, Marco; Grammatico, Andrea.

In: Journal of the American College of Cardiology, Vol. 46, No. 10, 15.11.2005, p. 1913-1920.

Research output: Contribution to journalArticle

Capucci, A, Santini, M, Padeletti, L, Gulizia, M, Botto, G, Boriani, G, Ricci, R, Favale, S, Zolezzi, F, Di Belardino, N, Molon, G, Drago, F, Villani, GQ, Mazzini, E, Vimercati, M & Grammatico, A 2005, 'Monitored atrial fibrillation duration predicts arterial embolic events in patients suffering from bradycardia and atrial fibrillation implanted with antitachycardia pacemakers', Journal of the American College of Cardiology, vol. 46, no. 10, pp. 1913-1920. https://doi.org/10.1016/j.jacc.2005.07.044
Capucci, Alessandro ; Santini, Massimo ; Padeletti, Luigi ; Gulizia, Michele ; Botto, GianLuca ; Boriani, Giuseppe ; Ricci, Renato ; Favale, Stefano ; Zolezzi, Francesco ; Di Belardino, Natale ; Molon, Giulio ; Drago, Fabrizio ; Villani, Giovanni Q. ; Mazzini, Elena ; Vimercati, Marco ; Grammatico, Andrea. / Monitored atrial fibrillation duration predicts arterial embolic events in patients suffering from bradycardia and atrial fibrillation implanted with antitachycardia pacemakers. In: Journal of the American College of Cardiology. 2005 ; Vol. 46, No. 10. pp. 1913-1920.
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abstract = "OBJECTIVES: The aim of our study was to evaluate arterial embolism (AE) occurrence rates and predictors in patients suffering from bradycardia and wearing a pacemaker with antitachycardia pacing therapies. BACKGROUND: Atrial fibrillation (AF) is associated with a high incidence of AE. METHODS: A total of 725 patients (360 men, age 71 ± 11 years) were implanted with a DDDRP pacemaker (Medtronic AT500, Medtronic Inc., Minneapolis, Minnesota). At baseline 225 (31.0{\%}) patients received antiplatelet therapy and 264 (36.4{\%}) patients received anticoagulation agents. RESULTS: Over a median 22-month follow-up (25th to 75th interquartile range 16 to 30 months), AE occurred in 14 (1.9{\%}) patients: 7 patients suffered a nonfatal ischemic stroke (0.6{\%} per year), 4 patients had transient ischemic attack (0.34{\%} per year), and 3 patients had embolic complications. Among baseline patients' characteristics, multivariate logistic analysis showed that embolic events are independently associated to ischemic heart disease (7.0 odds ratio [OR], 95{\%} confidence interval [CI] 2.3 to 21.3, p = 0.001), prior embolic event (7.3 OR, 95{\%} CI 1.2 to 43.9, p = 0.029), diabetes (5.0 OR, 95{\%} CI 1.2 to 15.7, p = 0.032), and hypertension (4.1 OR, 95{\%} CI 1.1 to 15.6, p = 0.036). The risk of embolism, adjusted for known risk factors, was 3.1 times increased (95{\%} CI 1.1 to 10.5, p = 0.044) in patients with device-detected atrial fibrillation episodes longer than one day during follow-up. CONCLUSIONS: In a cohort of patients with bradycardia and AF, arterial embolism was common in patients with ischemic cardiopathy, hypertension, diabetes mellitus, and in patients with known stroke risk factors. Atrial fibrillation occurrences longer than one day were independently associated with embolic events.",
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T1 - Monitored atrial fibrillation duration predicts arterial embolic events in patients suffering from bradycardia and atrial fibrillation implanted with antitachycardia pacemakers

AU - Capucci, Alessandro

AU - Santini, Massimo

AU - Padeletti, Luigi

AU - Gulizia, Michele

AU - Botto, GianLuca

AU - Boriani, Giuseppe

AU - Ricci, Renato

AU - Favale, Stefano

AU - Zolezzi, Francesco

AU - Di Belardino, Natale

AU - Molon, Giulio

AU - Drago, Fabrizio

AU - Villani, Giovanni Q.

AU - Mazzini, Elena

AU - Vimercati, Marco

AU - Grammatico, Andrea

PY - 2005/11/15

Y1 - 2005/11/15

N2 - OBJECTIVES: The aim of our study was to evaluate arterial embolism (AE) occurrence rates and predictors in patients suffering from bradycardia and wearing a pacemaker with antitachycardia pacing therapies. BACKGROUND: Atrial fibrillation (AF) is associated with a high incidence of AE. METHODS: A total of 725 patients (360 men, age 71 ± 11 years) were implanted with a DDDRP pacemaker (Medtronic AT500, Medtronic Inc., Minneapolis, Minnesota). At baseline 225 (31.0%) patients received antiplatelet therapy and 264 (36.4%) patients received anticoagulation agents. RESULTS: Over a median 22-month follow-up (25th to 75th interquartile range 16 to 30 months), AE occurred in 14 (1.9%) patients: 7 patients suffered a nonfatal ischemic stroke (0.6% per year), 4 patients had transient ischemic attack (0.34% per year), and 3 patients had embolic complications. Among baseline patients' characteristics, multivariate logistic analysis showed that embolic events are independently associated to ischemic heart disease (7.0 odds ratio [OR], 95% confidence interval [CI] 2.3 to 21.3, p = 0.001), prior embolic event (7.3 OR, 95% CI 1.2 to 43.9, p = 0.029), diabetes (5.0 OR, 95% CI 1.2 to 15.7, p = 0.032), and hypertension (4.1 OR, 95% CI 1.1 to 15.6, p = 0.036). The risk of embolism, adjusted for known risk factors, was 3.1 times increased (95% CI 1.1 to 10.5, p = 0.044) in patients with device-detected atrial fibrillation episodes longer than one day during follow-up. CONCLUSIONS: In a cohort of patients with bradycardia and AF, arterial embolism was common in patients with ischemic cardiopathy, hypertension, diabetes mellitus, and in patients with known stroke risk factors. Atrial fibrillation occurrences longer than one day were independently associated with embolic events.

AB - OBJECTIVES: The aim of our study was to evaluate arterial embolism (AE) occurrence rates and predictors in patients suffering from bradycardia and wearing a pacemaker with antitachycardia pacing therapies. BACKGROUND: Atrial fibrillation (AF) is associated with a high incidence of AE. METHODS: A total of 725 patients (360 men, age 71 ± 11 years) were implanted with a DDDRP pacemaker (Medtronic AT500, Medtronic Inc., Minneapolis, Minnesota). At baseline 225 (31.0%) patients received antiplatelet therapy and 264 (36.4%) patients received anticoagulation agents. RESULTS: Over a median 22-month follow-up (25th to 75th interquartile range 16 to 30 months), AE occurred in 14 (1.9%) patients: 7 patients suffered a nonfatal ischemic stroke (0.6% per year), 4 patients had transient ischemic attack (0.34% per year), and 3 patients had embolic complications. Among baseline patients' characteristics, multivariate logistic analysis showed that embolic events are independently associated to ischemic heart disease (7.0 odds ratio [OR], 95% confidence interval [CI] 2.3 to 21.3, p = 0.001), prior embolic event (7.3 OR, 95% CI 1.2 to 43.9, p = 0.029), diabetes (5.0 OR, 95% CI 1.2 to 15.7, p = 0.032), and hypertension (4.1 OR, 95% CI 1.1 to 15.6, p = 0.036). The risk of embolism, adjusted for known risk factors, was 3.1 times increased (95% CI 1.1 to 10.5, p = 0.044) in patients with device-detected atrial fibrillation episodes longer than one day during follow-up. CONCLUSIONS: In a cohort of patients with bradycardia and AF, arterial embolism was common in patients with ischemic cardiopathy, hypertension, diabetes mellitus, and in patients with known stroke risk factors. Atrial fibrillation occurrences longer than one day were independently associated with embolic events.

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