DETECTION OF ATRIAL FIBRILLATION IN PATIENTS WITH COMPLETE HEART BLOCK TREATED WITH DIFFERENT MODES OF PACEMAKER

Background: Atrial fibrillation (AF) and complete heart block (CHB) are significant cardiac conditions often managed with pacemaker implantation. Pacemaker mode may influence the detection and incidence of AF, a common and potentially severe complication in patients with CHB. This study evaluated the association between pacemaker mode (dual-chamber DDD vs. single-chamber VVI) and the incidence of AF in patients with CHB. Materials & Methods: A cross-sectional study was conducted from January 2021 to December 2021 among 114 CHB patients who received either DDD or VVI pacemakers at the Ibn Al-Bittar Specialized Center for Cardiac Surgery and Al-Nasiriyah Heart Center. Convenience sampling method was employed. Demographic and clinical data, including pacemaker type, duration of implantation, and comorbidities, were collected from medical records and structured interviews. AF incidence was assessed using electrocardiography (ECG) and pacemaker interrogation data. Statistical analysis was performed using chi-square and Fisher's exact tests, with a p-value < 0.05 considered significant. Results: Among the 114 patients (56 DDD, 58 VVI), 14% (n=16) developed AF. AF incidence was significantly higher in patients with VVI pacemakers (21%) compared to those with DDD pacemakers (7%) (p-value=0.034). No significant differences in AF incidence were observed between pacemaker modes based on gender, age, or the presence of comorbidities such as hypertension, diabetes, or smoking history (p-value>0.05). Conclusion: In summary, while DDD pacemakers may offer a protective effect against AF compared to VVI pacemakers, this study underscores the complexity of AF management in patients with CHB, indicating that a multifaceted approach is necessary to optimize outcomes.