Stroke in paced patients with sich sinus syndrome: Influence of left atrial function and size

Patients with sick sinus syndrome have a high prevalence of cerebral ischem ia. The present study was designed to establish the prevalence of stroke in patients with sick sinus syndrome and the role of atrial size and function . This prospective study analyzed 100 consecutive patients with sick sinus syndrome without atrial fibrillation who received either dual cham ber or v entricular pacemakers. Patients underwent a cranial CT scan at the time of enrollment and again at the end of the study 24 months later. Endpoint of t he study was cerebral ischemia. Clinical and echocardiographic features wer e assessed at the beginning of the study. A multivariate regression analysi s was applied to all variables that had at least a marginal univariate pred ictive value. Cerebral ischemia occurred in 18 patients. Univariate predict ors for embolism were age >65 years (p < 0.001), low atrial ejection force (p < 0.01) and a dilated left atrium with spontaneous echo contrast (p < 0. 05). These findings identified patients at high risk for the development of peripheral embolism among the group of patients paced for sick sinus syndr ome.