Prevalence Of Atrial Fibrillation In Patients With Permanent Pacemaker Implants And The Impact Of Pacing Mode On Frequency Of Atrial Arrhythmias: A Single Center Retrospective Study

Abstract

Background- Patients with pacemaker often develop atrial fibrillation. It may lead to adverse cardiac events like thromboembolic phenomenon and heart failure. Pacemakers allow continuous recording of underlying rhythm and helps to detect arrhythmias. The frequency of atrial fibrillation in patients with permanent pace maker implantation is not been widely studied in Indian population. Objective To identify frequency of atrial fibrillation in permanent pacemaker implants and to assess impact of mode on frequency of atrial fibrillation Methods – This study was carried out in patients who were implanted with permanent pacemaker in cardiology department at Himalayan Institute Of Medical Sciences(HIMS), Swami Rama Himalayan University(SRHU) from January 2017 to January 2021 and followed up every six months over 4 years for incidence of Atrial fibrillation (AF) detected via pacemaker interrogation and analysis of stored diagnostic data vis a vis documented clinical correlation. We also assessed the difference in incidence of atrial fibrillation between VVI (ventricular single chambered pacing) and Non VVI (AAI/DDD) mode (atrial single chambered pacing / dual chamber system). Result - Out of 414 individuals, 29 patients had a history of AF prior to permanent pacemaker implantation and 9 patients were lost in follow up. Out of 376 patients, 62 developed AF during follow up over a period of 4 years. AF was more common in VVI pacing compared to non VVI pacing. Majority of them were asymptomatic. Palpitation and dyspnea were common symptoms followed by stroke. LV dysfunction and LA enlargement were common echocardiographic findings in patients who developed AF.Conclusion – Atrial fibrillation is common among pacemaker patients irrespective of presence of atrial arrhythmia before pacemaker implantation. High incidence of AF was seen single chambered pacing VVI/AAI compared dual chambered pacing DDD .