Arrhythmias & electrophysiology
Adverse outcomes in patients with atrial fibrillation and a pacemaker: a cohort study
Authors' conclusion
Patients with AF and a PM experienced an increased rate of adverse cardiovascular outcomes. However, the PM itself was not independently associated with these outcomes.
Study context
- Population
- Patients with atrial fibrillation (AF) in two Swiss prospective cohorts, yearly follow-up up to 8 years445 (12.1%) with pacemaker (PM) at baseline
- Participants
- 3,675 patients
- Exposure
- Pacemaker vs no pacemaker
- Outcome
- MACE (stroke or TIA, MI, CV death, systemic embolism); HF hospitalization
- Follow-up
- Median 7 years
Methodological detailsmulticentre, 2 Swiss cohorts (Swiss-AF, Beat-AF), time-updated Cox regression
- Multicentre
- 2 Swiss cohorts (Swiss-AF, Beat-AF)
- Time-updated Cox regression
Main finding
As reported in the abstract
PM
- Major adverse cardiovascular events (MACE)
- 5.97 per 100 patient-years
- Heart failure (HF)
- 5.08 per 100 patient-years
No PM
- MACE
- 3.37 per 100 patient-years
- HF
- 2.61 per 100 patient-years
Major adverse cardiovascular events (MACE)
PM5.97 per 100 patient-years
No PM3.37 per 100 patient-years
Heart failure (HF)
PM5.08 per 100 patient-years
No PM2.61 per 100 patient-years
PM vs No PMAdjusted hazard ratio (95% CI)P value
MACE
1.12(0.95–1.33)
P = 0.183HF
1.14(0.94–1.37)
P = 0.180Observational data: associations, not effects.
Secondary outcomes
Individual components of MACE
- Consistent results (no independent association with PM)
Original publication
Adverse outcomes in patients with atrial fibrillation and a pacemaker: a cohort study. Europace. Published 28 October 2025. doi:10.
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