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European Heart Journal Advance Access published online on May 13, 2008
European Heart Journal, doi:10.1093/eurheartj/ehn192
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

Beneficial effects of statin therapy for prevention of atrial fibrillation following DDDR pacemaker implantation

Anne M. Gillis*, Margaret Morck, Derek V. Exner, Andrea Soo, M. Sarah Rose, Robert S. Sheldon, Henry J. Duff, Katherine M. Kavanagh, L. Brent Mitchell and D. George Wyse

Libin Cardiovascular Institute of Alberta and Department of Cardiac Sciences, University of Calgary and Calgary Health Region, HSC Room 1634, 3330 Hospital Drive NW, Calgary, AB, Canada T2N 4N1

Received 23 May 2007; revised 8 April 2008; accepted 17 April 2008.

* Corresponding author. Tel: +1 403 220 6841, Fax: +1 403 270 0313, Email: amgillis{at}ucalgary.ca

Aims: Data suggest that atrial pacing, statins, angiotensin-converting enzyme-inhibitors and angiotensin receptor blocking drugs prevent atrial tachycardia/atrial fibrillation (AT/AF) in some patients. The clinical predictors of AT/AF recurrence following dual-chamber pacemaker insertion were examined in 185 consecutive patients with paroxysmal AF.

Methods and results: Predictors of AT/AF recurrence were evaluated in this observational cohort study. The time to first AT/AF recurrence and AT/AF burden (h/day) was retrieved at each follow-up visit by interrogating the pacemaker. AT/AF recurred following pacemaker implantation in 157 (85%) patients. At 1 year of follow-up, patients without recurrence were more likely to be on statin therapy (54%) when compared with patients without statin therapy (25%, {chi} = 12.31, P = 0.0004). Statin therapy was the only significant predictor of AT/AF recurrence in a multivariate logistic regression model (adjusted odds ratio 0.33, 95% confidence interval 0.14–0.74, P = 0.007). AT/AF burden was significantly lower in the group on statin therapy (median 0.10 h/day) when compared with the group not on statin therapy (median 0.39 h/day, P = 0.0059).

Conclusion: AT/AF recurs frequently following pacemaker implantation in patients with sinus node disease. The progression to permanent AF remains low over time. Statin therapy was significantly associated with AT/AF suppression.

Key Words: Atrial fibrillation • Dual-chamber pacing • Statins


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