{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T15:01:37Z","timestamp":1792681297984,"version":"4.5.0"},"reference-count":25,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2021,8,16]],"date-time":"2021-08-16T00:00:00Z","timestamp":1629072000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003638","name":"Korea Health and Welfare Information Service","doi-asserted-by":"publisher","award":["HI15C1200"],"award-info":[{"award-number":["HI15C1200"]}],"id":[{"id":"10.13039\/501100003638","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003638","name":"Korea Health and Welfare Information Service","doi-asserted-by":"publisher","award":["HC19C0130"],"award-info":[{"award-number":["HC19C0130"]}],"id":[{"id":"10.13039\/501100003638","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Sinoatrial node dysfunction and atrial fibrillation (AF) frequently coexist and interact with each other, often to initiate and perpetuate each other.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine the effect of AF on the incidence and risk of sick sinus syndrome (SSS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The association of incident AF with the development of incident SSS was assessed from 2004 to 2014 in 302\u2009229 SSS\u2010 and pacemaker\u2010free subjects aged \u226560 years in the Korea National Health Insurance Service\u2010Senior cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During an observation period of 1\u2009854\u2009800 person\u2010years, incident AF was observed in a total of 12\u2009797 subjects (0.69%\/year). The incidence of SSS was 3.4 and 0.2 per 1000 person\u2010years in the propensity score\u2010matched incident AF and no\u2010AF groups, respectively. After adjustment, the significantly increased risk of SSS was observed in the incident AF group, with a hazard ratio (HR) of 13.4 (95% confidence interval [CI]: 8.4\u201321.4). This finding was consistently observed after censoring for heart failure (HR:\u00a016.0; 95% CI: 9.2\u201328.0) or heart failure\/myocardial infarction (HR: 16.6; 95% CI: 9.3\u201329.7). Incident AF also was associated with an increased risk of pacemaker implantation related with both SSS (HR:\u00a021.8; 95% CI: 8.7\u201318.4) and atrioventricular (AV) block (HR:\u00a09.5; 95% CI: 4.9\u201318.4). These results were consistent regardless of sex and comorbidities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Incident AF was associated with more than 10 times increased risk of SSS in an elderly population regardless of comorbidities. The risk of pacemaker implantations related with both sinus node dysfunction and AV block was increased in the elderly population with incident AF.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.15202","type":"journal-article","created":{"date-parts":[[2021,8,11]],"date-time":"2021-08-11T14:30:02Z","timestamp":1628692202000},"page":"2704-2714","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Risk of sick sinus syndrome in patients diagnosed with atrial fibrillation: A population\u2010based cohort"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6552-1742","authenticated-orcid":false,"given":"Pil\u2010Sung","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Cardiology, CHA Bundang Medical Center CHA University Seongnam Republic of 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