Abstract 17221: Incidence of Pacemaker-Detected Atrial Tachyarrhythmias in Elderly Patients with Hypertension and a History of Stroke or Transient Ischemic Attack
Background: Undiagnosed atrial fibrillation (AF) is believed to be an important cause of cryptogenic stroke. A dual-chamber pacemaker is the most sensitive method for diagnosing atrial fibrillation and in the ASSERT study pacemaker-detected AF was associated with a 2.5-fold increased risk of stroke. The incidence and time-course for AF development has not been reported for patients in ASSERT with a history of stroke or transient ischemic attack (TIA).
Methods: All patients had a dual-chamber pacemaker or defibrillator programmed to record AF. All patients had a history of hypertension, but none had a clinical history of AF.
Results: Of the 2580 patients in ASSERT, 186 had a prior history of stroke and 126 a TIA. Compared to patients without a history of stroke or TIA, those with TIA were older; those with stroke were more likely to be male or have diabetes and both groups were more likely to have a history of myocardial infarction or peripheral vascular disease (Table). The incidence of AF ≥ 6 minutes was the same in all three groups and occurred in one-third of patients (Table). Similarly, the incidence of longer episodes of pacemaker-detected AF and AF documented surface electrocardiogram were the same in all groups, as was the average time until the first documented AF episode, which occurred approximately one year after baseline (Table).
Conclusions: Pacemaker-detected AF is common in patients with a history of stroke or TIA, but is not any more common than in patients without prior cerebrovascular events.
- © 2012 by American Heart Association, Inc.