The role of pacemaker in the prevention of atrial fibrillation in
patients with sick sinus syndrome
Abstract
Objective: This retrospective study examined the relationship
between atrial pacing parameters and atrial fibrillation (AF) occurrence
in patients with sick sinus syndrome (SSS) who received dual-chamber
pacemakers. Methods: Sixty SSS patients who underwent dual
pacemaker implantation were studied. Demographics, clinical data, and
device information were collected, and patients were followed for up to
2 years post-implantation. Statistical analyses assessed the association
between atrial pacing parameters and AF development. Receiver operating
characteristic (ROC) analysis identified potential predictors of AF,
focusing on atrial pacing frequency and mode switch episodes.
Results: Higher atrial pacing frequency significantly reduced
AF risk at all time points (p<0.001), while lower pacing rates
did not correlate with AF incidence. The number of atrial premature
beats and mode switch episodes showed significant correlations with AF
occurrence in the early post-implantation period but lost significance
over time. Multivariable Cox regression analysis indicated that the
number of atrial premature beats had no significant effect on AF
development. However, an inverse relationship was observed between
atrial pacing frequency and AF occurrence in the first and third months
post-implantation. Conclusion: Maintaining a higher atrial
pacing frequency emerges as a valuable strategy to reduce AF risk in
dual-chamber pacemaker recipients with SSS. Notably, atrial premature
beats and mode-switching episodes primarily influenced AF risk during
the early post-implantation phase. This underscores the importance of
monitoring and optimizing atrial pacing parameters, especially in the
initial stages following pacemaker implantation, for effective AF
management in SSS patients.