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Objective: To investigate the incidence of recurrent atrial fibrillation, including asymptomatic atrial fibrillation, and the effect of left atrial volume index (LAVI) on recurrence of atrial fibrillation in elderly paroxysmal atrial fibrillation patients with implanted cardiac pacemakers., Methods: One hundred and forty eight elderly paroxysmal atrial fibrillation patients without antiarrhythmic drug therapy after car-diac pacemaker implantation were selected from January 2012 to December 2013 in this study. The baseline characteristics, echocardiography parameters, the incidence of recurrent atrial fibrillation and the burden of atrial fibrillation were recorded. The patients were divided into groups according to the burden of atrial fibrillation and the left atrial volume index. Multivariate Cox regression analysis was adopted to calculate the adjusted hazard ratio (HR) of left atrial volume index for the device-detected recurrence of atrial fibrillation and atrial fibrillation burden., Results: During an average of 22.79 months follow-up period, 57.43% of the patients with recurrence of atrial fibrillation, 22.97% of the pa-tients with high intensity burden of atrial fibrillation, and 15.54% of the patients with asymptomatic atrial fibrillation were found. Multivariate Cox regression analysis demonstrated left atrial enlargement (LAVI > 28 ml/m 2 ) was an independent risk factor for the device-detected recur-rence of atrial fibrillation ( P < 0.05) and atrial fibrillation burden ( P < 0.01)respectively., Conclusions: Left atrial volume index is an inde-pendent risk factor for the recurrence of atrial fibrillation and atrial fibrillation burden in elderly patients with paroxysmal atrial fibrillation after pacemaker implantation.

Background: Obesity is considered to be related to recurrence of atrial fibrillation (AF), left atrial thrombus formation, and atrial remodeling. However, whether obesity is an independent risk factor for stroke and other thromboembolic events is still controversial., Objective: This study aimed to investigate the effects of body mass index (BMI) on the risks of stroke, thromboembolism, and mortality in AF patients., Methods: Patients who were diagnosed with nonvalvular AF were included in this observational, retrospective study. The study population was stratified by BMI at baseline. The Cox proportional hazard model was adopted to calculate adjusted hazard ratios of risk factors for adverse clinical events (stroke, thromboembolism, and mortality)., Results: A total of 1286 AF patients (males, 78.30%; mean age, 74.50 years; 94.48% paroxysmal AF) were followed up for a median of 2.1 years (IQR: 1.5-2.9 years). Overall, 159 patients died. A total of 84 strokes and 35 thromboembolic events occurred. Multivariate analysis showed that overweight (25.0≤BMI<30.0 kg/m2) and age ≥75 years were independent risk factors for ischemic stroke (both P<0.01). Obesity (BMI ≥30.0 kg/m2), age ≥75 years, persistent/permanent AF, and prior thromboembolism were independent risk factors for thromboembolism (all P<0.05). Underweight (BMI <18.5 kg/m2), age ≥75 years, prior ischemic stroke/transient ischemic attack, renal dysfunction, and heart failure were independent risk factors for all-cause deaths (all P<0.05)., Conclusions: Overweight or obesity may be a risk factor of ischemic stroke and thromboembolism in AF patients. Excessive low weight is significantly associated with increased all-cause mortality.