Abstract 17719: Competitive Atrial Pacing is an Important Risk Factor for Occurrence of Atrial Fibrillation in Paced Patients: Analysis of RATE Registry Data

During pacemaker (PMR) or defibrillator (ICD) follow-up, atrial tachycardia or atrial fibrillation (AT/AF) of various durations is often documented by device electrograms (EGM). However, inasmuch as certain device algorithms may cause competitive atrial pacing (CAP) resulting from: internal sensor triggered pacing, retrograde VA conduction or combination of refractory periods, we hypothesized that CAP would be associated with AT/AF events, and could even initiate AT/AF due to atrial pacing early after a P wave. Methods: The RATE registry, a multicenter observational study of device patients (pts) (2238 ICDs and 3142 PMRs) followed between 2007 and 2012, was designed to evaluate the clinical implications of device detected AT/AF. In a randomly chosen subset of RATE pts, every EGM during 20± 6.6 months of follow-up was adjudicated by both a physician and a clinical engineer. Pts were considered “positive” for a diagnosis if ANY EGM during follow up documented that diagnosis, and negative if NO EGM documente...