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

Research output: Contribution to journalArticle

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

ASJC Scopus subject areas

  • Nursing(all)

Fingerprint Dive into the research topics of 'Monitored atrial fibrillation duration predicts arterial embolic events in patients suffering from bradycardia and atrial fibrillation implanted with antitachycardia pacemakers'. Together they form a unique fingerprint.

  • Cite this

    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, G. Q., 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, 46(10), 1913-1920. https://doi.org/10.1016/j.jacc.2005.07.044