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Europace Advance Access published online on March 8, 2008
Europace, doi:10.1093/europace/eun014
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

Mortality in patients with atrial fibrillation has significantly decreased during the last three decades: 35 years of follow-up in 1627 pacemaker patients

Stefan Asbach1, Manfred Olschewski2, Thomas S. Faber1, Manfred Zehender1, Christoph Bode1 and Michael Brunner1,*

1 Medizinische Klinik III, Kardiologie und Angiologie, Universitätsklinik Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany; 2 Institut für medizinische Biometrie und Informatik der Universitätsklinik Freiburg, Germany

Aim: The impact of atrial fibrillation (AF) on mortality is not fully understood. We therefore sought to investigate long-term effects of AF on mortality in patients with the need for pacemaker (PM) therapy.

Methods and results: A total of 1627 PM recipients with AF at implantation were followed in a single-centre, longitudinal study for up to 35 years. Baseline factors affecting survival and long-term follow-up were analysed. A total of 7362 patient-years of follow-up (PM implanted between 1971 and 2000, followed until 31 December 31 2005) were analysed. Female PM recipients lived significantly longer than male (P = 0.025; mean survival 91.9 vs. 72.1 months) despite older age at time of inclusion. Mean survival times almost doubled for patients implanted in the last decade, with 139.8 months in the nineties vs. 66.8 months in the seventies and 75.7 months in the eighties (P < 0.001). Male gender, age at implantation, non-syncopal bradycardia, and decade of implantation influenced survival.

Conclusion: Life expectancy in AF patients after PM implantation has doubled within the last three decades, with a mean survival in the overall population of 7.6 years for women and 6.0 years for men. Survival is influenced by several simple baseline characteristics, which may help to identify patients with very long survival times.

Key Words: Atrial fibrillation, Pacemaker, Mortality

* Corresponding author. Tel: +49 761 270 3401; fax: +49 761 270 3799. E-mail address: brunner{at}medizin.ukl.uni-freiburg.de

Manuscript submitted 15 November 2007. Accepted after revision 7 January 2008.


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