Author + information
- Received March 30, 1994
- Revision received October 26, 1994
- Accepted November 7, 1994
- Published online April 1, 1995.
- Mark E. Hamer, MD*,
- William E. Wilkinson, PhD,
- Walter K. Clair, MD,
- Richard L. Page, MD, FACC,
- Elizabeth A. McCarthy, RN and
- Edward L.C. Pritchett, MD
- ↵*Present address and address for correspondence: Dr. Mark E. Hamer, Division of Cardiology, Burch 300, Evanston Hospital, 2650 Ridge Avenue, Evanston, Illinois 60201.
Objectives. This study was performed to determine the incidence of symptomatic, sustained atrial fibrillation in a group of patients with paroxysmal supraventricular tachycardia. The effects of the mechanism of paroxysmal supraventricular tachycardia (atrioventricular [AV] node reentry vs. AV reentry through an accessory pathway) and heart rate during the tachycardia on the occurrence of atrial fibrillation were also assessed.
Background. There is a substantial incidence of atrial fibrillation in patients with paroxysmal supraventricular tachycardia, but the precise incidence and the factors that determine it are unknown.
Methods. One hundred sixty-nine patients with paroxysmal supraventricular tachycardia were followed up by regular clinic visits and transtelephonic electrocardiographic monitoring during symptomatic episodes of arrhythmia. The Kaplan-Meier product-limit method was used to estimate the proportion of patients remaining free of atrial fibrillation during the observation period. The Cox proportional hazards model was used to assess the effect of mechanism and heart rate during paroxysmal supraventricular tachycardia on the atrial fibrillation—free period.
Results. Thirty-two (19%) of the 169 patients had an episode of atrial fibrillation during a mean follow-up period of 31 months. The cumulative percent of patients experiencing an episode of atrial fibrillation was 6% within 1 month, 9% within 4 months and 12% within 1 year. The mechanism of paroxysmal supraventricular tachycardia was not associated with the time to occurrence of atrial fibrillation; the hazard ratio corresponding to classification in the AV node reentry group was 0.8 (p > 0.6). The heart rate during paroxysmal supraventricular tachycardia was not associated with the time to occurrence of atrial fibrillation; the hazard ratio associated with an increase in heart rate of 50 beats/min during the tachycardia was 1.15 (p > 0.5).
Conclusions. This study suggests that atrial fibrillation will develop in ∼12% of patients with paroxysmal supraventricular tachycardia during a 1-year follow-up period. The occurrence of atrial fibrillation is not related to the mechanism or heart rate of the paroxysmal supraventricular tachycardia.
This study was supported in part by Grant R01 HL40392 from the National Heart, Lung, and Blood Institute and by Grant M01 RR30 from the National Center for Research Resources, National Institutes of Health, Bethesda, Maryland.
- Received March 30, 1994.
- Revision received October 26, 1994.
- Accepted November 7, 1994.
- North American Society of Pacing and Electrophysiology; American College of Cardiology; American Heart Association, Inc.; and European Society of Cardiology.