Incidence of new onset atrial fibrillation in patients with permanent pacemakers and the relation to the pacing mode

Sarmad Said, Chad J. Cooper, Haider Alkhateeb, Sucheta Gosavi, Alok Dwivedi, Eduardo Onate, David Paez, Zainul Abedin

Research output: Contribution to journalReview articlepeer-review

12 Scopus citations


Background: Atrial fibrillation is a relatively common arrhythmia often seen in patients with permanent pacemakers. In this study we aimed to assess the incidence of atrial fibrillation in patients whose pacemakers were programmed to pace in the right ventricle (VVI) and compared it with patients whose pacemakers were programmed in non- VVI mode(i.e. AAI or DDD). Material/Methods: Records of the patients with permanent pacemaker or implantable-cardioverter-defibrillator were evaluated and analyzed. These patients had regular periodic follow-up evaluation over the last 10 years. (January 1, 2002 to December 31, 2012). Patient demographic, pacemaker data, pacing mode, review and analysis of arrhythmia log for occurrence of new atrial fibrillation and echocardiographic findings for left atrial size, mitral regurgitation, were analyzed and recorded. Left atrial size was classified as mild, moderate or severe enlargement, depending on the left atrial dimension. Results: Average age was 68 years. There was no gender predominance (51% male). Mean follow-up duration was 6 years and 3 months. Hispanic population represented the majority of the patients (65.4%). Majority of the devices (80.0%) were programmed as DDD pacing mode. Fifty-five patients (52.8%) did not develop atrial fibrillation. 85.7% of the patients paced in VVI-mode had atrial fibrillation while atrial fibrillation occurred in 37.4% among patients paced in non-VVI-mode. This difference was statistically significant (P<0.0001). Conclusions: Right ventricular pacing in a VVI mode was associated with higher incidence of atrial fibrillation, mitral regurgitation and left atrial enlargement. Non-VVI based pacing demonstrated lower incidence of new onset atrial fibrillation.

Original languageEnglish (US)
Pages (from-to)268-273
Number of pages6
JournalMedical Science Monitor
StatePublished - Feb 18 2014
Externally publishedYes


  • Artificial
  • Atrial fibrillation
  • Mitral valve insufficiency
  • Pacemaker

ASJC Scopus subject areas

  • General Medicine


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