Ungureanu Adrian-Ionuț, Târtea Georgică, Docea Anca Oana, Negroiu Cristina Elena, Marginean Cristina Maria, Mitruț Radu, Deutsch Marina-Carmen, Țieranu Eugen, Vătășescu Radu-Gabriel, Mitruț Paul
Doctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.
Department of Cardiology, Emergency County Hospital of Craiova, 200642 Craiova, Romania.
Life (Basel). 2025 Mar 13;15(3):450. doi: 10.3390/life15030450.
(1) Background: Atrial fibrillation (A Fib) is a common arrhythmia that affects millions of people worldwide and is characterized by irregular and often rapid heartbeats that can cause stroke. The aim of our study was to assess the importance of predictors for the occurrence of atrial fibrillation in patients with cardiac pacemakers and to analyze their impact on these patients, especially the impact of hepatic impairment. (2) Methods: This study is an observational, retrospective study, including 182 patients who were implanted with a dual-chamber pacemaker (DDD), with no known history of A Fib. (3) Results: We identified as predictors for the occurrence of atrial fibrillation in patients with cardiac pacemakers, DDD with rate response mode, NYHA class III of heart failure, as well as the presence of hepatic impairment (HI). Analysis of echocardiographic parameters of the left atrium revealed a larger left atrial volume as well as a larger left atrial area compared to patients who had a much smaller area at baseline and who did not experience any atrial fibrillation at follow-up. The fact that there were no statistically significant differences between the two groups of patients in terms of left atrial ejection fraction at baseline was very interesting. Patients in the A Fib group had a higher percentage of atrial pacing at the 9-month follow-up (86.23 ± 22.19%) compared to patients in the group without A Fib (44.92 ± 29.99%, < 0.0001) and had a 9-month follow-up rate of A Fib of 25.806% vs. 2.247% in those with a low percentage of atrial pacing ( < 0.0001). The percentage of ventricular pacing at the 9-month follow-up, the observations were almost similar. (4) Conclusions: The importance of pacemakers in detecting subclinical episodes of atrial fibrillation remains crucial for the prevention of embolic events in these patients. Hepatic impairment may be a risk factor for the occurrence of atrial fibrillation in patients with pacemakers, but it can also create significant problems in stroke prevention.
(1) 背景：心房颤动（房颤）是一种常见的心律失常，全球数百万人受其影响，其特征为心跳不规则且常快速，可导致中风。我们研究的目的是评估心脏起搏器患者发生房颤的预测因素的重要性，并分析它们对这些患者的影响，尤其是肝功能损害的影响。(2) 方法：本研究是一项观察性回顾性研究，纳入182例植入双腔起搏器（DDD）且无房颤病史的患者。(3) 结果：我们确定心脏起搏器患者发生房颤的预测因素为具有频率应答模式的DDD、纽约心脏协会（NYHA）心功能III级以及存在肝功能损害（HI）。对左心房超声心动图参数的分析显示，与基线时左心房面积小得多且随访期间未发生任何房颤的患者相比，房颤患者的左心房容积和左心房面积更大。两组患者在基线时左心房射血分数方面无统计学显著差异这一事实非常有趣。房颤组患者在9个月随访时心房起搏百分比（86.23±22.19%）高于无房颤组患者（44.92±29.99%，P<0.0001），房颤组9个月随访时房颤发生率为2（5.806%，而心房起搏百分比低的患者为2.247%（P<0.0001）。在9个月随访时心室起搏百分比方面，观察结果几乎相似。(4) 结论：起搏器在检测房颤亚临床发作方面的重要性对于预防这些患者的栓塞事件仍然至关重要。肝功能损害可能是起搏器患者发生房颤的危险因素，但在预防中风方面也可能产生重大问题。
