Highlights
- •New-onset AF was detected in 21% of patients with CIEDs.
- •Age, diabetes mellitus, heart failure, and left atrial enlargement predicted new-onset AF.
- •Four clinical factors provide clinically useful risk assessment of new-onset AF.
Abstract
Introduction
Cardiac implantable electronic devices (CIEDs) can detect atrial fibrillation (AF)
early and accurately. Risk factors for the development of new-onset AF in patients
with CIEDs remains uncertain.
Methods
Patients with CIEDs who visited Chiba University Hospital between January 2016 and
December 2016 were enrolled. We only included patients without single chamber CIEDs
or a known history of AF.
Results
Of 371 patients with CIEDs, 78 (21.0%; median age 61.0 years, 65.5% male) developed
new-onset AF. Multivariate analysis demonstrated that independent predictors for the
development of new or incident AF were age ≥65 years (odd ratio [OR] 2.76, 95% confidence
interval [CI] 1.54–4.96, P = 0.001), diabetes mellitus (OR 2.24, 95% CI 1.20–4.19,
P = 0.011), congestive heart failure (OR 1.94, 95% CI 1.06–3.54, P = 0.031), and left
atrial volume index >34 ml/m2 (OR 3.51, 95% CI 1.96–6.25, P < 0.001). Based on these 4 clinical factors (age ≥ 65,
diabetes mellitus, congestive heart failure, left atrial volume index > 34 ml/m2) there was a good predictive ability for new AF development (AUC 0.728) and clinically
usefulness using decision curve analysis.
Conclusions
A substantial number of patients with CIEDs develop new-onset AF. Four clinical factors
(age ≥ 65, diabetes mellitus, congestive heart failure, left atrial volume index > 34 ml/m2) independently predicted new-onset AF and may provide an approach to clinically useful
risk assessment for incident AF.
Keywords
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Article info
Publication history
Published online: February 26, 2018
Accepted:
February 21,
2018
Received in revised form:
January 30,
2018
Received:
October 22,
2017
Identification
Copyright
© 2018 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
