Table 3.
Prevalence of Newly Detected AF in Nonstroke Populations With Implanted Permanent Pacemakers or Cardioverter-Defibrillators
| Study/Year | Device Type and Indication | Patient Profile | Definition of AF | Follow-Up Duration | Prevalence of AT/AF, n (%) |
|---|---|---|---|---|---|
| Gillis and Morck,22
2002 |
PPMs for all indications | All | 180 bpm, number of beats for atrial tachycardia detection of 200 | 718±383 d | 126/231 (55) |
| MOST,23 2003 | PPMs for SND | All | Atrial rate >220 bpm for >5 min | 27 mo | 156/312 (50) |
| Tse and Lau,24 2006 | PPMs for SND | All | Not defined | 84 mo | 99/226 (44) with at least 1 episode, and 30/139 (22) patients without a history of AF |
| SAFE Registry,25 2008 | PPMs for all indications | No prior AF | AT with an atrial rate ≥180 bpm lasting ≥5 min | 6 mo | 150/1501 (10) 5–60 min in 26 (76) |
| TRENDS,26 2009 | PPMs, ICDs, or CRT for all indications | ≥1 Stroke risk factor (CHF, hypertension, age >65 y, DM, or prior TE) | AT/AF defined atrial rate >175 bpm for >20 s AT/AF burden over prior 30-d period subsets: zero, low (<5.5 h), and high (≥5.5 h) |
1.4 y | PPM: 1234/2486 (49.6) ICD: 781/2486 (31.4) CRT: 471/2486 (19.0) |
| Botto et al,27 2009 | PPMs for tachy-brady syndrome | Prior atrial arrhythmias documented | >5 min of AF | 1 y | AF for 24 h: (39.2) AF for 5 min: (31.5) AF-free: (29.2) |
| ASSERT,14 2012 | PPMs and ICDs for all indications | Age >65 y, history of hypertension, no history of AF | Atrial rate >190 bpm for >6 min | 2.5 y | At 3 mo: 261/2580 (10.1) An additional 633 patients (24.5) during 2.5-y follow-up: 894/2580 (34.7) |
| Healey et al,28 2013 | PPMs for all indications | All | Not defined | 51.5 ± 39.7 mo | AF was detected by the pacemaker in 246/445 patients (55.3), 65.8% of the 111 patients with a clinical history of AF before PPM implantation |
| Gonzalez et al,29 2014 | PPMs for all indications | No history of AF | AHREs >178 bpm | 6 mo | 39/224 (17.4) |
| Benezet-Mazuecos et al,30 2015 | PPMs and ICDs for all indications | All | Atrial rate ≥225 bpm with a minimum duration of 5 min | 12 mo | 28/109 (25.7) |
| Lima et al,31 2016 | PPMs for all indications | Age >60 y | AF was the designation for AHREs >2 min in AT histogram >250 bpm | Average follow-up of 15.7±7.7 mo | 63/300 (21) |
AF indicates atrial fibrillation; AHRE, atrial high-rate episode; ASSERT, Asymptomatic Atrial Fibrillation and Stroke Evaluation in Pacemaker Patients and the Atrial Fibrillation Reduction Atrial Pacing Trial; AT, atrial tachyarrhythmia; CHF, congestive heart failure; CRT, cardiac resynchronization therapy; DM, diabetes mellitus; ICD, implantable cardioverter-defibrillator; MOST, Mode Selection Trial; PPM, permanent pacemaker; SAFE, Silent Atrial Fibrillation Detection With Stored EGMs; SND, sinus node dysfunction; TE, thromboembolic event; and TRENDS, A Prospective Study of the Clinical Significance of Atrial Arrhythmias Detected by Implanted Device Diagnostics.