Diana Delić-Brkljačić

Incidence and predictors of asymptomatic atrial fibrillation in patients older than 70 years with complete atrioventricular block and dual chamber pacemaker implantation

Aim To evaluate predictors of asymptomatic atrial fibrillation in patients older than 70 years with complete atrioventricular (AV) block, normal left ventricular systolic function, and implanted dual chamber (DDD) pacemaker. Methods Hundred and eighty six patients with complete AV block were admitted over one year to the Sisters of Mercy University Hospital. The study recruited patients older than 70 years, with no history of atrial fibrillation, heart failure, or reduced left ventricular systolic function. All the patients were implanted with the same pacemaker. Out of 103 patients who were eligible for the study, 81 (78%) were evaluated. Follow-up time ranged from 12 to 33 months (average±standard deviation 23 ± 5 months). Primary end-point was asymptomatic atrial fibrillation occurrence recorded by the pacemaker. Atrial fibrillation occurrence was defined as atrial high rate episodes (AHRE) lasting >5 minutes. Binary logistic regression was used to identify the predictors of development of asymptomatic atrial fibrillation. Results The 81 patients were stratified into two groups depending on the presence of AHRE lasting >5 minutes (group 1 had AHRE>5 minutes and group 2 AHRE<5 minutes). AHRE lasting >5 minutes were detected in 49 (60%) patients after 3 months and in 53 (65%) patients after 18 moths. After 3 months, only hypertension (odds ratio [OR], 17.63; P = 0.020) was identified as a predictor of asymptomatic atrial fibrillation. After 18 months, hypertension (OR, 14.0; P = 0.036), P wave duration >100 ms in 12 lead ECG (OR, 16.5; P = 0.001), and intracardial atrial electrogram signal amplitude >4 mV (OR, 4.27; P = 0.045) were identified as predictors of atrial fibrillation. Conclusion In our study population, hypertension was the most robust and constant predictor of asymptomatic atrial fibrillation after 3 months, while P wave duration >100 ms in 12-lead ECG and intracardial atrial signal amplitude were predictors after 18 months.

Persistent Atrial Fibrillation is Associated with a Poor Prognosis in Patients with Atrioventricular Block and Dual‐Chamber Pacemaker

Background : The prognostic significance of development of persistent atrial fibrillation (AF) in patients with atrioventricular (AV) block and dual chamber (DDD) pacemakers has not been separately investigated. We sought to determine whether persistent AF influences clinical outcome in these patients.

A rare case of Corynebacterium Spp. native mitral valve endocarditis – case report and review of literature

ORCID: Krešimir Kordić, https://orcid.org/0000-0002-9707-6946 • Nikola Kos, https://orcid.org/0000-0001-8829-2543 Nikola Bulj, https://orcid.org/0000-0002-7859-3374 • Matias Trbušić, https://orcid.org/0000-0001-9428-454X Ivo Darko Gabrić, https://orcid.org/0000-0003-4719-4634 • Ozren Vinter, https://orcid.org/0000-0002-4236-7594 Igor Rudež, https://orcid.org/0000-0002-7735-6721 • Diana Delić-Brkljačić, https://orcid.org/0000-0002-7116-2360