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Chronic atrial fibrillation in patients with paroxysmal atrial fibrillation, atrioventricular node ablation and pacemakers - Determinants and treatment

Lookup NU author(s): Dr Janet McComb


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Aims This study examined the factors associated with the development of chronic (or permanent) atrial fibrillation (AF) in patients who had undergone atrioventricular (AV) node ablation with permanent pacing because of paroxysmal AF. Methods A retrospective review of case notes of all 65 consecutive patients identified as having had paroxysmal atrial arrhythmias, AV node ablation and permanent pacemaker implantation was performed. Atrial rhythm was established from all pacing records and from the surface EGG. Treatment with anti-arrhythmic drugs and with warfarin was recorded. A multivariate analysis was undertaken. using atrial rhythm on final ECG and chronic AF as outcome measures. Results During a mean follow-up of 30 months, 42% of patients with paroxysmal AF had developed chronic AF. Multivariate analysis showed that increasing age, history of electrical cardioversion and VVI pacing all contributed to the development of chronic AF. 25/62 patients were taking warfarin, and four had had strokes (2.5%/year). Conclusion The majority of patients with paroxysmal atrial arrhythmias treated with AV node ablation and pacing develop chronic BF eventually. Stroke remains a risk, particularly in those who develop chronic AF.

Publication metadata

Author(s): McComb JM, Gribbin GM

Publication type: Article

Publication status: Published

Journal: Europace

Year: 1999

Volume: 1

Issue: 1

Pages: 30-34

Print publication date: 01/01/1999

ISSN (print): 1099-5129

ISSN (electronic): 1532-2092

Publisher: Oxford University Press


DOI: 10.1053/eupc.1998.0009


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