3.4. Risk of pacemaker implantation
In patients with incident AF, a total of 107 participants had pacemaker implantation during the follow-up period of 36,536 person-years, compared with 358 no-AF patients who needed pacemaker implantation. The incidence of pacemaker implantation was 2.9 and 0.1 per 1000 person-years in the incident AF and PS-matched no-AF groups, respectively. As quantified by the clinical variable and competing risk of mortality, patients with incident AF had an increased risk of pacemaker implantation (adjusted HR, 9.4; 95% CI: 7.5–11.8). Even after PS matching, the risk of pacemaker implantation was still significantly high in those with incident AF (adjusted HR, 15.2; 95% CI: 9.1–25.6) (Table 3).
The incidence of SSS-related pacemaker implantation was 0.05 and 1.3 per 1000 person-years in the incident AF and PS-matched no-AF patients, respectively. Incident AF was associated with an increased risk of SSS-related pacemaker implantation (adjusted HR, 21.8; 95% CI: 8.7–18.4). The incidence of pacemaker implantation associated with AV block was 0.1 and 1.3 per 1000 person-years in the incident AF and PS-matched no-AF groups, respectively. Incident AF was associated with an increased risk of pacemaker implantation due to AV block (adjusted HR, 9.5; 95% CI: 4.9–18.4, p<0.001) (Table 3).