Influence of pacing modalities on the incidence of atrial fibrillation in patients without prior atrial fibrillation: a prospective study.

Aim. Many studies suggest that patients who receive a physiological pacemaker have a reduced incidence of atrial fibrillation compared to patients receiving a ventricular pacemaker. Methods. In order to evaluate the impact of different pacing modalities on the incidence of atrial fibrillation, we prospectively analysed 210 patients. Patients with previous episodes of atrial fibrillation were excluded from the study. The patient population included 110 patients paced for sick sinus syndrome and 100 patients paced for total atrioventricular block or second degree type atrioventricular block. Results. Patients were followed for 5 years; the incidence of atrial fibrillation was 10% at 1 year, 23% at 3 years and 31% at 5 years. There was an increase in the incidence of atrial fibrillation in patients receiving a ventricular pacemaker compared to patients receiving a physiological pacemaker. Conclusion. The pacing modality appeared to influence the incidence of atrial fibrillation in paced patients; patients with ventricular pacing had a significantly higher incidence of arrhythmias than did patients with physiological pacing.