Asymptomatic atrial fibrillation in patients with atrial fibrillation and implanted pacemaker

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• 作者：Michal Witkowski ; ^{michalwitkowski13@gmail.com} ; Andrzej Bissinger ; Tomasz Grycewicz ; Andrzej Lubinski
• 关键词：Atrial fibrillation ; Silent atrial fibrillation ; Asymptomatic atrial fibrillation ; Pacemaker ; Prevalence
• 刊名：International Journal of Cardiology
• 出版年：2017
• 出版时间：15 January 2017
• 年：2017
• 卷：227
• 期：Complete
• 页码：583-588
• 全文大小：393 K
• 卷排序：227

文摘

Atrial fibrillation is the most common chronic arrhythmia. Due to diagnostic difficulties, the exact prevalence of silent atrial fibrillation is not precisely defined.AimThe main aim of the present study was to assess the prevalence of asymptomatic atrial fibrillation and the relation between clinical status and presence of symptoms of atrial fibrillation.Material and methodsFifty patients with implanted pacemaker with atrial fibrillation recording function and diagnosed paroxysmal atrial fibrillation were enrolled to the study in order to detect episodes of atrial fibrillation. Episodes lasting > 1 min were included into analysis. Patients were evaluated for presence of atrial fibrillation symptoms.ResultsA total of 870 atrial fibrillation episodes were registered, the majority (93%) were asymptomatic. Episodes occurred more often during the day than during the night (p < 0.001). Asymptomatic episodes occurred 13 times more frequently than symptomatic (p < 0.001). Majority of episodes lasting up to 5 min were asymptomatic, while episodes lasting over 24 h were usually symptomatic (p < 0.001). Furthermore, there were association between silent atrial fibrillation and lower HR (p = 0.003), higher percentage of atrial (p = 0.01) and ventricular pacing (p < 0.001), male gender (p < 0.001), presence of atrioventricular block (p < 0.003), lower NYHA class (p < 0.002), and calcium channel blockers (p = 0.033) and diuretics intake (p < 0.001).ConclusionIn patients with bradycardia permanent pacemakers and paroxysmal atrial fibrillation, the proportion of asymptomatic episodes is very high. It was observed that shorter duration of the episodes, male gender, lower heart rate, presence of atrioventricular block, lower NYHA class, higher percentage of atrial and ventricular pacing, Ca2 + blockers, and diuretics intake predisposed to silent atrial fibrillation.