Atrial High-Rate Event Incidence and Predictors in Patients With Permanent Pacemaker Implantation

Abstract

Objective: The present study aims to investigate the incidence and predictors of atrial high-rate events (AHREs) in patients with permanent pacemaker implants.Methods: A total of 289 patients who were implanted with a dual-chamber pacemaker due to complete atrioventricular block or symptomatic sick sinus syndrome (SSS) and had no previous history of atrial fibrillation were included in the present study. AHREs are defined as events with an atrial frequency of ≥175 bpm and a duration of ≥5 min. The patients were divided into two groups according to whether or not AHREs were detected during the follow-up: group A (AHRE+, n = 91) and group N (AHRE–, n = 198).Results: During the 12-month follow-up period, AHREs were detected in 91 patients (31.5%). The multivariate Cox regression analysis revealed that patient age [odds ratio [OR] = 1.041; 95% confidence interval [CI], 1.018–1.064; and P < 0.001], pacemaker implantation due to symptomatic SSS (OR = 2.225; 95% CI, 1.227–4.036; and P = 0.008), and the percentage of atrial pacing after pacemaker implantation (OR = 1.010; 95% CI, 1.002–1.017; and P = 0.016) were independent AHRE predictors.Conclusion: The AHRE detection rate in patients with pacemaker implants was 31.5%. Patient age, pacemaker implantation due to symptomatic SSS, and the percentage of atrial pacing after pacemaker implantation were independent AHRE predictors.

New-onset atrial high-rate episodes in left bundle branch area pacing versus right ventricular pacing for patients with atrioventricular block

“…Su et al [25] demonstrated success rate of 97.8% in patients undergoing LBBAP with stable thresholds during a mean follow-up of 18.6 months. Particularly, LBBAP is safe and effective in patients ≥80 years old [26], and as AHREs may increase with aging [27,28], older people may benefit more from LBBAP. Additionally, HBP was associated with a significantly higher risk of complications compared with LBBAP (8.6% vs. 1.3%; P = 0.04), mainly because of more lead-related complications, whereas LBBAP was associated with a risk of complications similar to that of RVP (3.5% vs.…”