TY - JOUR
T1 - Risk factors for the development of recurrent atrial fibrillation
T2 - Role of pacing and clinical variables
AU - Reimold, Sharon C.
AU - Lamas, Gervasio A.
AU - Cantillon, Catherine O.
AU - Antman, Elliott M.
N1 - Funding Information:
From the Cardiovascular Division, Department of Medicine, The Brigham and Women's Hospital. Dr. Reimold is a recipient of a Clinical Investigator Development Award from the National Heart, Lung, and Blood Institute (HL-02758). Received for publication May 31, 1994; accepted Oct. 10, 1994. Reprint requests: Sharon C. Reimold, MD, Cardiovascular Division, Department of Medicine, The Brigham and Women's Hospital, 75 Francis St., Boston, MA 02115. Copyright @ 1995 by Mosby-Year Book, Inc. 0002-8703/95/$3.00 + 0 4/1/61983
PY - 1995/6
Y1 - 1995/6
N2 - Atrial fibrillation recurs in many patients treated with antiarrhythmic therapy to maintain sinus rhythm. From March 1985 to August 1991, 214 patients with recurrent symptomatic chronic or paroxysmal atrial fibrillation for which conventional antiarrhythmic agents had failed were treated with propafenone or sotalol. Baseline demographic data including the presence of pacing therapy were collected. Life-table estimates of the duration of freedom from atrial fibrillation were constructed on the basis of pacemaker status. Of 214 patients, 26 (12.1 %) had pacing therapy. Patients with dual-chamber pacing were more likely to remain in sinus rhythm at 6 months (80%) than were patients with ventricular pacing (40%) or patients without pacing therapy (55%) (p = 0.002). A Cox univariate regression analysis demonstrated that dual-chamber pacing in contrast to ventricular pacing or no pacing was associated with a lower risk of recurrent atrial fibrillation. Clinical parameters such as age, gender, left atrial size, fibrillation pattern, drug assignment, ejection fraction, and underlying cardiac disease did not alter the risk of recurrent atrial fibrillation. Dual-chamber pacing was associated with a decreased likelihood of recurrent atrial fibrillation even after adjustment for other clinical covariates in a multivariate model (p = 0.04). In patients with recurrent atrial fibrillation treated with propafenone or sotalol, dual-chamber pacing improved maintenance of sinus rhythm.
AB - Atrial fibrillation recurs in many patients treated with antiarrhythmic therapy to maintain sinus rhythm. From March 1985 to August 1991, 214 patients with recurrent symptomatic chronic or paroxysmal atrial fibrillation for which conventional antiarrhythmic agents had failed were treated with propafenone or sotalol. Baseline demographic data including the presence of pacing therapy were collected. Life-table estimates of the duration of freedom from atrial fibrillation were constructed on the basis of pacemaker status. Of 214 patients, 26 (12.1 %) had pacing therapy. Patients with dual-chamber pacing were more likely to remain in sinus rhythm at 6 months (80%) than were patients with ventricular pacing (40%) or patients without pacing therapy (55%) (p = 0.002). A Cox univariate regression analysis demonstrated that dual-chamber pacing in contrast to ventricular pacing or no pacing was associated with a lower risk of recurrent atrial fibrillation. Clinical parameters such as age, gender, left atrial size, fibrillation pattern, drug assignment, ejection fraction, and underlying cardiac disease did not alter the risk of recurrent atrial fibrillation. Dual-chamber pacing was associated with a decreased likelihood of recurrent atrial fibrillation even after adjustment for other clinical covariates in a multivariate model (p = 0.04). In patients with recurrent atrial fibrillation treated with propafenone or sotalol, dual-chamber pacing improved maintenance of sinus rhythm.
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U2 - 10.1016/0002-8703(95)90393-3
DO - 10.1016/0002-8703(95)90393-3
M3 - Article
C2 - 7754943
AN - SCOPUS:0029019967
SN - 0002-8703
VL - 129
SP - 1127
EP - 1132
JO - American heart journal
JF - American heart journal
IS - 6
ER -