Incidence of Atrial fibrillation in patient with Permanent pacemaker

Background: Atrial fibrillation (AF) is a common cardiac arrhythmia linked to significant morbidity, particularly in pacemaker patients. Pacemakers, crucial for managing bradycardia and conduction disorders, may increase AF risk, especially in those with dual-chamber devices or conditions like Sick Sinus Syndrome.Objective: To evaluate the incidence of atrial fibrillation (AF) in patients with permanent pacemakers and identify key predictors of AF. Materials and Methods: This prospective observational study included 250 patients who received permanent pacemakers between January 2022 and December 2022. AF and atrial high-rate episodes (AHREs) were monitored during the one-year follow-up of patients. Data were collected on patient demographics, pacemaker type, and clinical characteristics. Predictors of AF were identified through logistic regression analysis.Results: AF was detected in 20% of the patients, with a higher incidence in those with dual-chamber pacemakers (14%) compared to single-chamber devices (6%). An AF risk that was significantly elevated was associated with Sick Sinus Syndrome (OR = 2.50, p = 0.0005). AHRE detection was the strongest predictor of AF (OR = 3.00, p = 0.0001). Age and the type of pacemaker were also significant predictors. These findings highlight the importance of regular monitoring and early intervention in high-risk patients.Conclusion: The study reveals a substantial risk of AF in pacemaker patients, particularly in those with dual-chamber devices and underlying Sick Sinus Syndrome. Key predictors, such as AHRE detection, advanced age, and pacemaker type, underscore the need for vigilant monitoring and tailored management strategies to improve patient outcomes.Keywords: Atrial fibrillation, Atrial high-rate episodes, Dual-chamber, Pacemaker, Sick Sinus Syndrome.