Atrial Size Independently Correlates with the Development of Paroxysmal Atrial Fibrillation in Patients with Sick Sinus Syndrome.docVIP

Original Article 659 Atrial Size Independently Correlates with the Development of Paroxysmal Atrial Fibrillation in Patients with Sick Sinus Syndrome Yu-Sheng Lin1,3, MD; G. Bih-Fang Guo2, MD; Yung-Lung Chen2, MD; Tzu-Hsien Tsai2, MD; Kuo-Li Pan1,3, MD; Wen-Hao Liu2, MD; Chien-Jen Chen2, MD; Cheng-Hsu Yang2, MD; Chih-Yuan Fang2, MD; Yuan-Kai Hsieh2, MD; Mien-Cheng Chen2, MD Background: Atrial fibrillation arises in 20-30% of patients with sick sinus syndrome, increasing the risk of systemic embolization and mortality. The aim of this study was to examine the clinical determinants of development of paroxys- mal atrial fibrillation in sick sinus syndrome patients before implantation of a pacemaker. Methods: This case-control survey involved 144 patients (mean age? SD age: 72? 9 years) in whom implantation of a transvenous permanent pacemaker was planned for sick sinus syndrome. Patients were classified into two groups, patients with (n = 71) and without (n = 73) a history of paroxysmal atrial fib- rillation before implantation. Clinical characteristics and echocardiographic parameters were analyzed. Results: The peri-implant right atrial area and left atrial area were significantly larger in patients with, than those without, paroxysmal atrial fibrillation. Multiple logistic regression analysis identified that the size of the left atrial area inde- pendently correlated with the development of atrial fibrillation: each 1 cm 2 increase in left atrial area corresponded to a 44% increase in risk (odds ratio = 1.44 [1.22, 1.71]; p 0.001). Conclusions: The left atrial size independently correlates with the development of parox- ysmal atrial fibrillation in sick sinus syndrome patients before pacemaker implantation. (Chang Gung Med J 2010;33:659-67) Key words: atrial fibrillation, atrial size, sick sinus syndrome S ick sinus syndrome (SSS) is the most frequent indication for pacemaker implantation, and it