Document Detail

Relationship between atrial tachyarrhythmias and symptoms.
MedLine Citation:
PMID:  15851283     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: The purpose of this study was to correlate patient-reported symptoms of atrial fibrillation with the underlying rhythm. BACKGROUND: The reliability of patient-reported symptoms as a marker of atrial fibrillation recurrence has not been well studied. METHODS: This prospective multicenter trial correlated the recurrence of atrial tachyarrhythmias with symptoms in patients with a history of atrial fibrillation and a standard indication for permanent pacing. Pacemaker-detected atrial tachyarrhythmia events were correlated with symptoms. Patients logged symptomatic events into the device's memory via an external manual activator. Patients were followed for 12 months and were contacted weekly to ensure compliance with activator usage. Episodes were classified as symptomatic atrial tachyarrhythmia, asymptomatic atrial tachyarrhythmia, or symptomatic nonatrial tachyarrhythmia depending on concordance between patient symptoms and the rhythm. RESULTS: Forty-eight patients underwent implantation of a DDDRP pacemaker and were followed for 12 +/- 2 months. A median of 25.0 (4.0-55.8) symptomatic events attributed to atrial fibrillation. A median of 1.0 (0.0-10.0) symptomatic atrial tachyarrhythmia episodes were documented during follow-up. Symptoms related to atrial fibrillation were reported in 6% of atrial tachyarrhythmia episodes identified by the pacemaker. The probability that symptoms were associated with an atrial tachyarrhythmia (positive predictive value) was 17%. The ventricular rate between symptomatic and asymptomatic atrial tachyarrhythmia events was not significantly different. CONCLUSIONS: Among patients with symptomatic bradycardia and a history of atrial fibrillation, symptoms of atrial fibrillation often were not associated with documented atrial tachyarrhythmias, and more than 90% of atrial tachyarrhythmias were clinically silent.
S Adam Strickberger; John Ip; Sanjeev Saksena; Ken Curry; Tristram D Bahnson; Paul D Ziegler
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  2     ISSN:  1547-5271     ISO Abbreviation:  Heart Rhythm     Publication Date:  2005 Feb 
Date Detail:
Created Date:  2005-04-26     Completed Date:  2005-06-08     Revised Date:  2009-10-27    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  United States    
Other Details:
Languages:  eng     Pagination:  125-31     Citation Subset:  IM    
Division of Cardiology, Washington Hospital Center, Washington, DC 20010, USA.
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MeSH Terms
Atrial Fibrillation / physiopathology*
Pacemaker, Artificial
Prospective Studies
Sensitivity and Specificity
Tachycardia, Ectopic Atrial / physiopathology*
Comment In:
Heart Rhythm. 2005 Feb;2(2):132-3   [PMID:  15851284 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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