Permanent pacemaker implantation after valve and arrhythmia surgery in patients with preoperative atrial fibrillation

Kowalewski, Mariusz; Pasierski, Michał; Finke, Janina; Kołodziejczak, Michalina; Staromłyński, Jakub; Litwinowicz, Radosław; Filip, Grzegorz; Kowalówka, Adam; Wańha, Wojciech; Bławat, Przemysław; Łoś, Andrzej; Stefaniak, Sebastian; Wojakowski, Wojciech; Jemielity, Marek; Rogowski, Jan; Deja, Marek; Jagielak, Dariusz; Bartuś, Krzysztof; Sierakowska, Katarzyna; Mariani, Silvia; Li, Tong; Ravaux, Justine M.; Matteucci, Matteo; Ronco, Daniele; Jiritano, Federica; Fina, Dario; Martucci, Gennaro; Meani, Paolo; Raffa, Giuseppe Maria; Malvindi, Pietro Giorgio; Lorusso, Roberto; Suwalski, Piotr

doi:10.1016/j.hrthm.2022.04.007

Cited by 11 publications

(4 citation statements)

References 20 publications

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“… 19 Therefore, there is an urgent need to educate people and raise awareness about this significant association, as well as promote the appropriate use of antithrombotic agents. Additionally, with the global population aging, more patients will undergo permanent pacemaker implantation, 20 , 21 and the high discontinuation of OAC in elderly patients with AF should receive considerable attention.…”

Section: Discussionmentioning

confidence: 99%

Non‑persistence to Oral Anticoagulation Therapy in Elderly Patients with Non‑valvular Atrial Fibrillation

Cao,

Feng,

et al. 2023

PPA

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Purpose To investigate the reasons for elderly atrial fibrillation (AF) patients not continuing their oral anticoagulation (OAC) treatment and the factors that influence this behavior. Methods Elderly AF patients (aged≥75 years) hospitalized from December 2019 to May 2022 were consecutively enrolled. Clinical, demographic, and concomitant medication data were collected. The endpoint was defined as OAC discontinuation for more than 30 days or a switch to an alternative therapy. Predictors of OAC non-persistence were investigated using a multivariable Cox regression model. Results This study included 560 participants (51.1% men, mean age 80.9±0.2 years). During a median follow-up of 20 months, medication persistence was observed in 322 patients (57.5%). Non-persistence was found to be significantly higher with warfarin than with NOAC (48.8% vs 33.6%, p = 0.006). In the multivariate analysis, OAC non-persistence was independently predicted by a history of permanent pacemaker implantation, the use of antiplatelet drugs, employee Medicare, living with children, college degree or above, and persistent AF (HR = 1.580, 1.586, 0.604, 0.668, 0.028, 0.769, p < 0.05, respectively). Treatment discontinuation within 3 months of discharge was observed in a large number of patients (81.8%). Medication discontinuation due to bleeding was more frequently observed in patients who continued for longer than 3 months (p < 0.001), while discontinuation due to patient preference was more frequent in those with shorter durations (≤3 months) (p = 0.049). Patient preference was the second leading cause of non-persistence in patients, regardless of whether they were taking warfarin or NOAC. Conclusion OAC non-persistence remains high among elderly AF patients during long-term follow-up, with a significant proportion discontinuing shortly after discharge. This pattern of non-persistence is heavily influenced by demographic factors and patient preference. Further interventions should be developed based on the reasons and risk factors to improve persistence and initiated early in the treatment process.

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Section: Discussionmentioning

confidence: 99%

Non‑persistence to Oral Anticoagulation Therapy in Elderly Patients with Non‑valvular Atrial Fibrillation

Cao,

Feng,

et al. 2023

PPA

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“…The application of electronic pacemakers had improved the quality of life for many patients with SSS, but it still has problems with infection, post-cardiac injury syndrome, wire loss and limited electronic life ( 60 ). In addition, many patients were not suitable or unwilling to undergo permanent pacemaker implantation ( 61 ).…”

Section: Discussionmentioning

confidence: 99%

Trends in research on sick sinus syndrome: A bibliometric analysis from 2000 to 2022

Zhang

Zhao

Zhou

et al. 2022

Front. Cardiovasc. Med.

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Sick sinus syndrome (SSS) is a refractory arrhythmia disease caused by the pathological changes of sinoatrial node and its adjacent tissues. 2,251 publications related to SSS were retrieved from Web of Science database from 2000 to 2022 and analyzed by using VOS viewer and CiteSpace software. The results showed the United States dominated the field, followed by Japan, Germany, and China. SSS was closely related to risk factors such as atrial fibrillation and aging. Sick sinus syndrome, atrial fibrillation and sinus node dysfunction were the top three keywords that had the strongest correlation with the study. Pacemaker implantation, differentiation and mutation are research hotspots currently. Clinical studies on SSS found that sick sinus syndrome, atrial fibrillation, and pacemakers were the top three keywords that had the largest nodes and the highest frequency. In the field of basic applied research and basic research, atrial fibrillation and pacemaker cells were the focus of research. In conclusion, bibliometric analysis provided valuable information for the prevention, treatment and future research trends of SSS.

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“… 1308 , 1382 , 1389 , 1390 However, in a recent large European registry of patients undergoing valve surgery, surgical AF ablation was not associated with increased need for permanent pacemaker implantation. 1391 Sinus node dysfunction requiring permanent pacemaker implantation can occur in up to 10% of patients after the Cox maze procedure for non-paroxysmal AF and may be a result of unmasking preexisting sick sinus syndrome. 1392 In addition, mechanical or thermal injury to the sinus or AV node and interruption of the conduction system arterial supply are the main intraoperative reasons for postoperative bradycardia and in-hospital permanent pacemaker implantation.…”

Section: Surgical and Hybrid Atrial Fibrillation Ablationmentioning

confidence: 99%

2024 European Heart Rhythm Association/Heart Rhythm Society/Asia Pacific Heart Rhythm Society/Latin American Heart Rhythm Society expert consensus statement on catheter and surgical ablation of atrial fibrillation

Tzeis,

Gerstenfeld,

Kalman

et al. 2024

Europace

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In the last three decades, ablation of atrial fibrillation (AF) has become an evidence-based safe and efficacious treatment for managing the most common cardiac arrhythmia. In 2007, the first joint expert consensus document was issued, guiding healthcare professionals involved in catheter or surgical AF ablation. Mounting research evidence and technological advances have resulted in a rapidly changing landscape in the field of catheter and surgical AF ablation, thus stressing the need for regularly updated versions of this partnership which were issued in 2012 and 2017. Seven years after the last consensus, an updated document was considered necessary to define a contemporary framework for selection and management of patients considered for or undergoing catheter or surgical AF ablation. This consensus is a joint effort from collaborating cardiac electrophysiology societies, namely the European Heart Rhythm Association, the Heart Rhythm Society, the Asia Pacific Heart Rhythm Society, and the Latin American Heart Rhythm Society .

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Permanent pacemaker implantation after valve and arrhythmia surgery in patients with preoperative atrial fibrillation

Cited by 11 publications

References 20 publications

Non‑persistence to Oral Anticoagulation Therapy in Elderly Patients with Non‑valvular Atrial Fibrillation

Non‑persistence to Oral Anticoagulation Therapy in Elderly Patients with Non‑valvular Atrial Fibrillation

Trends in research on sick sinus syndrome: A bibliometric analysis from 2000 to 2022

2024 European Heart Rhythm Association/Heart Rhythm Society/Asia Pacific Heart Rhythm Society/Latin American Heart Rhythm Society expert consensus statement on catheter and surgical ablation of atrial fibrillation

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