title: Anticoagulation Management in Patients with Pacemaker-Detected Atrial Fibrillation.
abstract: BACKGROUND
  In patients with an implanted pacemaker, asymptomatic atrial fibrillation (AF) is associated with an increased risk of thrombo-embolic complications. There is still no consensus which duration of episodes of atrial fibrillation should be taken as an indicator for inclusion of oral anticoagulation therapy (OAC).
  
  
  METHODS
  A total of 104 patients who had no AF episodes in the past and have an indication for permanent pacing were included in the study.
  
  
  RESULTS
  During an average follow-up of 18 months, 33 of the patients developed episodes of AF. Inclusion of OAC was performed in 17 patients, in whom AF was recorded, although in all patients CHA2DS2-VASc score was ≥ 1. The inclusion of OAC showed a statistically significant correlation with increasing duration of episodes of AF (r = 0.502, p = 0.003). During the follow-up period none of the patients developed thrombo-embolic complication.
  
  
  CONCLUSIONS
  Considering that our group of patients had no thrombo-embolic events, we could conclude that dividing the AF episodes in less than 1% in 24 hours and longer than 1% within 24 hours could be an indicator for decision-making to include OAK if the CHA2DS2-VASc score is ≥ 1.
authors.affiliation: University Clinic of Cardiology, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia.
authors.forename: Lidija
authors.initials: L
authors.lastname: Poposka
authors.affiliation: University Clinic of Cardiology, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Boskov
authors.affiliation: University Clinic of Cardiology, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia.
authors.forename: Dejan
authors.initials: D
authors.lastname: Risteski
authors.affiliation: University Clinic of Cardiology, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia.
authors.forename: Jane
authors.initials: J
authors.lastname: Taleski
authors.affiliation: University Clinic of Cardiology, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia.
authors.forename: Ljubica
authors.initials: L
authors.lastname: Georgievska-Ismail
keywords: anticoagulants; asymptomatic; atrial fibrillation; pacemaker; thrombo-embolic events