title: Atrial size independently correlates with the development of paroxysmal atrial fibrillation in patients with sick sinus syndrome.
abstract: BACKGROUND
  Atrial fibrillation arises in 20-30% of patients with sick sinus syndrome, increasing the risk of systemic embolization and mortality. The aim of this study was to examine the clinical determinants of development of paroxysmal atrial fibrillation in sick sinus syndrome patients before implantation of a pacemaker.
  
  
  METHODS
  This case-control survey involved 144 patients (mean age ± SD age: 72 ± 9 years) in whom implantation of a transvenous permanent pacemaker was planned for sick sinus syndrome. Patients were classified into two groups, patients with (n = 71) and without (n = 73) a history of paroxysmal atrial fibrillation before implantation. Clinical characteristics and echocardiographic parameters were analyzed.
  
  
  RESULTS
  The peri-implant right atrial area and left atrial area were significantly larger in patients with, than those without, paroxysmal atrial fibrillation. Multiple logistic regression analysis identified that the size of the left atrial area independently correlated with the development of atrial fibrillation: each 1 cm2 increase in left atrial area corresponded to a 44% increase in risk (odds ratio = 1.44 [1.22, 1.71]; p < 0.001).
  
  
  CONCLUSIONS
  The left atrial size independently correlates with the development of paroxysmal atrial fibrillation in sick sinus syndrome patients before pacemaker implantation.
authors.affiliation: Division of Cardiology, Chang Gung Memorial Hospital at Chiayi, Chang Gung University Collage of Medicine, Taoyuan, Taiwan, ROC.
authors.forename: Yu-Sheng
authors.initials: YS
authors.lastname: Lin
authors.forename: G Bih-Fang
authors.initials: GB
authors.lastname: Guo
authors.forename: Yung-Lung
authors.initials: YL
authors.lastname: Chen
authors.forename: Tzu-Hsien
authors.initials: TH
authors.lastname: Tsai
authors.forename: Kuo-Li
authors.initials: KL
authors.lastname: Pan
authors.forename: Wen-Hao
authors.initials: WH
authors.lastname: Liu
authors.forename: Chien-Jen
authors.initials: CJ
authors.lastname: Chen
authors.forename: Cheng-Hsu
authors.initials: CH
authors.lastname: Yang
authors.forename: Chih-Yuan
authors.initials: CY
authors.lastname: Fang
authors.forename: Yuan-Kai
authors.initials: YK
authors.lastname: Hsieh
authors.forename: Mien-Cheng
authors.initials: MC
authors.lastname: Chen
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000209:etiology* / Q000473:pathology*; D016022:Case-Control Studies; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006325:Heart Atria / Q000473:pathology; D006801:Humans; D008297:Male; D012804:Sick Sinus Syndrome / Q000150:complications*