title: Beneficial effects of statin therapy for prevention of atrial fibrillation following DDDR pacemaker implantation.
abstract: OBJECTIVE
  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.
  
  
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary and Calgary Health Region, Calgary, AB, Canada. amgillis@ucalgary.ca
authors.forename: Anne M
authors.initials: AM
authors.lastname: Gillis
authors.forename: Margaret
authors.initials: M
authors.lastname: Morck
authors.forename: Derek V
authors.initials: DV
authors.lastname: Exner
authors.forename: Andrea
authors.initials: A
authors.lastname: Soo
authors.forename: M Sarah
authors.initials: MS
authors.lastname: Rose
authors.forename: Robert S
authors.initials: RS
authors.lastname: Sheldon
authors.forename: Henry J
authors.initials: HJ
authors.lastname: Duff
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Kavanagh
authors.forename: L Brent
authors.initials: LB
authors.lastname: Mitchell
authors.forename: D George
authors.initials: DG
authors.lastname: Wyse
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000209:etiology / Q000517:prevention & control*; D002304:Cardiac Pacing, Artificial / Q000009:adverse effects*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D016015:Logistic Models; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D055502:Secondary Prevention; D013610:Tachycardia / Q000209:etiology / Q000517:prevention & control; D013997:Time Factors
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors