Incidence And Influence Factors Of New Onset Rapid Atrial Arrhythmias Patients With Permanent Pacemakers

Objective：1. To assess the incidence of new onset RAT sick sinus symptom(SSS) or high-degree (third-degree or second-degree type Ⅱ)atrioventricular block (AVB) patients with permanent pacemakersof the2nd Hospital of Jilin University.2. To investigate the influence factors of new onset rapid atrialarrhythmias (RAT) patients with permanent pacemakers, and providesome references in the prevention and treatment of the disease.Methods：We collected the hospitalized SSS or high-degree AVB patients withpermanent pacemakers from January1,2013to October30,2014in theDepartment of Cardiology of the2nd Hospital of Jilin University.Thedate were collected from the medical history, the laboratory examinationresults and the follow-up results. Patients were excluded from the studyfor any of the following reasons:1. patients with atrial tachyarrhythmiabefore pacemaker implantation，including atrial tachycardia (AT), atrialflutter (AFL), atrial fibrillation (AF).2. The existence of the otherdiseases that can cause atrial arrhythmias, such as valvular heart disease,cardiomyopathy, constrictive pericarditis, pulmonary heart disease,hyperthyroidism, metabolism disorder.3. The long term and regularprescription of antiarrhythmic drugs after pacemaker implantation. A retrospective study was performed on60eligible patients. All thepacemakers were first implanted and in accordance with the class I and IIa indication. We recorded the detailed demographic and clinicalcharacteristics, including gender, age at implantation, history of smokingand drinking, history of coronary heart disease, hypertension and diabetes,lipids, heart function, prescription of angiotensin-convertingenzymeinhibitor (ACEI)/angiotensin receptor blocker (ARB) and statin,the size of left atrium (LA) before pacemaker implantation, pacing mode(VVI pacing mode, non-VVI pacing mode), indication for pacemakerimplantation(SSS/high-degree AVB). The endpoint was the occurrence ofnew onset of atrial tachyarrhythmia, we divided hem into two groups forstatistical analysis. Statistical methods: All statistical analyses werecarried out using SPSS18.0，and single logistic regression were used toanalyses the association of considered influences with RAT. Thesignificant variables (P<0.05) in single logistic regression (unadjustedlogistic regression) were considered for multivariable logistic regressionanalysis. We used odds ratio (OR) with95%confidence interval (CI) andp-values to describe the results of logistic regression. P-values less than5%were considered as significant results.Result：1. There were16patients (26.7%) developed atrial tachyarrhythmia,including3cases (5%) with AT,1case (1.7%) with AFL,12cases (20%) with AF. The other patients did not developed rapid atrialarrhythmias during follow-up.2. Univariate logistic regression analysis indicated that history ofsmoking and drinking, history of coronary heart disease andhypertension, heart function, prescription of ACEI/ARB, the size ofLA before pacemaker implantation, pacing mode were significantvariables (P<0.05). Multivariate logistic regression analysis thathistory of coronary heart disease and hypertension, prescription ofACEI/ARB remained significant.Conclusion：1. The rapid atrial arrhythmias had a higher incidence after pacemakerimplantation, especially AF, consistent with the domestic researchresults, slightly lower than the foreign research results.2. The history of coronary heart disease and hypertension, heart function,prescription of ACEI/ARB, the size of LA before pacemakerimplantation, pacing mode were associated with the new onset RATpatients with permanent pacemakers, especially the history ofcoronary heart disease, hypertension, andprescription of ACEI/ARB.Gender, age, history of smoking and drinking, diabetes, dyslipidemia,history of statin,diagnosis were not in this study.