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Europace 1999 1(1):30-34; doi:10.1053/eupc.1998.0009
© 1999 by European Society of Cardiology
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Chronic atrial fibrillation in patients with paroxysmal atrial fibrillation, atrioventricular node ablation and pacemakers

Determinants and treatment

J. M. McComb and G. M. Gribbin

Regional Cardiothoracic Centre, Freeman Hospital Newcastle upon Tyne, U.K.

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 ECG. 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).

Conclusions

The majority of patients with paroxysmal atrial arrhythmias treated with AV node ablation and pacing develop chronic AF eventually. Stroke remains a risk, particularly in those who develop chronic AF.

Key Words: Atrial fibrillation, paroxysmal, atrioventricular node ablation, permanent pacemaker, DDD, VVI, stroke.

Correspondence: Dr J. M. McComb, Regional Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne, NE7 7DN, U.K.


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T. R. Betts
Atrioventricular junction ablation and pacemaker implant for atrial fibrillation: still a valid treatment in appropriately selected patients
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M. Brignole, M. Gammage, L. Jordaens, R. Sutton, and on behalf of the Barcelona Discussion Group
Report of a study group on ablate and pace therapy for paroxysmal atrial fibrillation
Europace, January 1, 1999; 1(1): 8 - 13.
[Abstract] [PDF]


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