{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T10:37:54Z","timestamp":1760783874950,"version":"3.44.0"},"reference-count":38,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Heart"],"accepted":{"date-parts":[[1998,11,25]]},"published-print":{"date-parts":[[1999,4,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>To evaluate whether thromboembolism in sick sinus syndrome can be predicted by pacing mode, atrial fibrillation, or echocardiographic findings.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec sec-type=\"methods\">\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>Patients were randomised to single chamber atrial (n\u2009=\u2009110) or ventricular (n\u2009=\u2009115) pacing. They were divided into subgroups with and without brady-tachy syndrome at time of randomisation. The occurrence of atrial fibrillation and thromboembolism during follow up were investigated and compared with echocardiographic findings.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>The annual risk of thromboembolism was 5.8% in patients with brady-tachy syndrome randomised to ventricular pacing, 3.2% in patients without brady-tachy syndrome randomised to ventricular pacing, 3% in patients with brady-tachy syndrome randomised to atrial pacing, and 1.5% in patients without brady-tachy syndrome randomised to atrial pacing. In atrial paced patients without brady-tachy syndrome at randomisation and without atrial fibrillation during follow up, the annual risk of thromboembolism was 1.4%. Left atrial size measured by M\u2009mode echocardiography was of no value in predicting thromboembolism.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Arterial thromboembolism in patients with sick sinus syndrome is very common and is associated primarily with brady-tachy syndrome at randomisation and with ventricular pacing. The risk of thromboembolism is small in atrial paced patients in whom atrial fibrillation has never been documented.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/hrt.81.4.412","type":"journal-article","created":{"date-parts":[[2014,10,22]],"date-time":"2014-10-22T15:31:45Z","timestamp":1413991905000},"page":"412-418","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":18,"title":["Arterial thromboembolism in patients with sick sinus syndrome: prediction from pacing mode, atrial fibrillation, and echocardiographic findings"],"prefix":"10.1136","volume":"81","author":[{"given":"H R","family":"Andersen","sequence":"first","affiliation":[{"name":"Department of Cardiology, Skejby Sygehus, Aarhus University Hospital, 8200 Aarhus N, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J C","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Skejby Sygehus, Aarhus University Hospital, 8200 Aarhus N, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P E B","family":"Thomsen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Skejby Sygehus, Aarhus University Hospital, 8200 Aarhus N, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L","family":"Thuesen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Skejby Sygehus, Aarhus University Hospital, 8200 Aarhus N, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A K","family":"Pedersen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Skejby Sygehus, Aarhus University Hospital, 8200 Aarhus N, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P T","family":"Mortensen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Skejby Sygehus, Aarhus University Hospital, 8200 Aarhus N, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T","family":"Vesterlund","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Skejby Sygehus, Aarhus University Hospital, 8200 Aarhus N, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1999,4,1]]},"reference":[{"key":"2025092021544691000_81.4.412.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(97)03425-9"},{"key":"2025092021544691000_81.4.412.2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.97.10.987"},{"key":"2025092021544691000_81.4.412.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(94)90347-6"},{"key":"2025092021544691000_81.4.412.4","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1161\/01.CIR.46.1.5","article-title":"Clinical spectrum of the sick sinus syndrome.","volume":"46","author":"Rubenstein","year":"1972","journal-title":"Circulation"},{"key":"2025092021544691000_81.4.412.5","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.58.6.1072"},{"key":"2025092021544691000_81.4.412.6","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.88.3.1045"},{"key":"2025092021544691000_81.4.412.7","doi-asserted-by":"crossref","first-page":"2080","DOI":"10.1111\/j.1540-8159.1990.tb06946.x","article-title":"Differences between atrial single chamber pacing (AAI) and ventricular single chamber pacing (VVI) with respect to prognosis and antiarrhythmic effect in patients with sick sinus syndrome.","volume":"13","author":"Stangl","year":"1990","journal-title":"PACE"},{"key":"2025092021544691000_81.4.412.8","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(92)90018-I"},{"key":"2025092021544691000_81.4.412.9","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(88)90244-X"},{"key":"2025092021544691000_81.4.412.10","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(90)91379-K"},{"key":"2025092021544691000_81.4.412.11","doi-asserted-by":"crossref","first-page":"1575","DOI":"10.1111\/j.1540-8159.1988.tb06277.x","article-title":"Long-term follow up of patients with sick sinus syndrome: a comparison of clinical aspects among unpaced, ventricular inhibited paced, and physiologically paced groups.","volume":"11","author":"Sasaki","year":"1988","journal-title":"PACE"},{"key":"2025092021544691000_81.4.412.12","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197607222950403"},{"key":"2025092021544691000_81.4.412.13","first-page":"220","article-title":"Sick sinus syndrome: natural history before and after pacing.","volume":"3","author":"Santini","year":"1993","journal-title":"Eur J Card Physiol Electrophysiol"},{"key":"2025092021544691000_81.4.412.14","doi-asserted-by":"crossref","first-page":"1110","DOI":"10.1111\/j.1540-8159.1986.tb06678.x","article-title":"The natural history of sick sinus syndrome.","volume":"9","author":"Sutton","year":"1986","journal-title":"PACE"},{"key":"2025092021544691000_81.4.412.15","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1161\/01.STR.19.6.712","article-title":"Ischemic stroke after cardiac pacemaker implantation in sick sinus syndrome.","volume":"19","author":"Fisher","year":"1988","journal-title":"Stroke"},{"key":"2025092021544691000_81.4.412.16","unstructured":"Santini M Ansalone G Auriti A (1997) Stroke in sinus node disease. in Cardiac pacing: new advances. ed Rosenqvist M (WB Saunders Co, London), pp 101\u2013119."},{"key":"2025092021544691000_81.4.412.17","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1994.00420130036007"},{"key":"2025092021544691000_81.4.412.18","first-page":"143","article-title":"Comparison of atrial and VVI pacing modes in symptomatic sinus node dysfunction without associated tachyarrhythmias.","volume":"42","author":"Sethi","year":"1990","journal-title":"Indian Heart J"},{"key":"2025092021544691000_81.4.412.19","doi-asserted-by":"crossref","unstructured":"Sasaki S Takeuchi A Ohzeki M (1983) Long-term follow up of paced patients with sick sinus syndrome. in Cardiac pacing. Proceedings of the VIIth world symposium on cardiac pacing. eds Steinbach K Glokar D Laszkovics A (Steinkopff Verlag, Darmstadt), pp 85\u201390.","DOI":"10.1007\/978-3-642-72367-4_13"},{"key":"2025092021544691000_81.4.412.20","doi-asserted-by":"crossref","first-page":"1","DOI":"10.7326\/0003-4819-116-1-1","article-title":"Predictors of thromboembolism in atrial fibrillation: I. Clinical features of patients at risk.","volume":"116","year":"1992","journal-title":"Ann Intern Med"},{"key":"2025092021544691000_81.4.412.21","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(90)90323-S"},{"key":"2025092021544691000_81.4.412.22","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.92.4.835"},{"key":"2025092021544691000_81.4.412.23","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1111\/j.1540-8159.1993.tb01572.x","article-title":"Platelet aggregability in patients with a VVI pacemaker.","volume":"16","author":"Fazio","year":"1993","journal-title":"PACE"},{"key":"2025092021544691000_81.4.412.24","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1136\/hrt.78.4.358","article-title":"Effects of atrioventricular asynchrony on platelet activation: implication of thromboembolism in paced patients.","volume":"78","author":"Lau","year":"1997","journal-title":"Heart"},{"key":"2025092021544691000_81.4.412.25","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.77.5.428"},{"key":"2025092021544691000_81.4.412.26","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.78.3.262"},{"key":"2025092021544691000_81.4.412.27","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1111\/j.1540-8159.1991.tb05086.x","article-title":"Efficacy of ticlopidine in the prevention of thromboembolic events in patients with VVI pacemakers.","volume":"14","author":"Fazio","year":"1991","journal-title":"PACE"},{"key":"2025092021544691000_81.4.412.28","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199011293232201"},{"key":"2025092021544691000_81.4.412.29","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.84.2.527"},{"key":"2025092021544691000_81.4.412.30","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(86)90318-2"},{"key":"2025092021544691000_81.4.412.31","doi-asserted-by":"publisher","DOI":"10.1016\/S0033-0620(96)80037-5"},{"key":"2025092021544691000_81.4.412.32","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1161\/01.STR.28.1.72","article-title":"Thromboembolism prophylaxis in chronic atrial fibrillation. Practice patterns in community and tertiary-care hospitals.","volume":"28","author":"Munschauer","year":"1997","journal-title":"Stroke"},{"key":"2025092021544691000_81.4.412.33","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.71.1.92"},{"key":"2025092021544691000_81.4.412.34","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1007\/BF02598984","article-title":"Failure to prescribe warfarin to patients with nonrheumatic atrial fibrillation.","volume":"11","author":"Antani","year":"1996","journal-title":"J Gen Intern Med"},{"key":"2025092021544691000_81.4.412.35","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1997.00440250097011"},{"key":"2025092021544691000_81.4.412.36","doi-asserted-by":"crossref","first-page":"746","DOI":"10.1161\/01.STR.28.4.746","article-title":"Primary care physician-reported secondary and tertiary stroke prevention practices. A comparison between the United States and the United Kingdom.","volume":"28","author":"Goldstein","year":"1997","journal-title":"Stroke"},{"key":"2025092021544691000_81.4.412.37","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1987.00370090041008"},{"key":"2025092021544691000_81.4.412.38","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(89)91200-2"}],"container-title":["Heart"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/hrt.81.4.412","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,21]],"date-time":"2025-09-21T04:54:58Z","timestamp":1758430498000},"score":1,"resource":{"primary":{"URL":"https:\/\/heart.bmj.com\/lookup\/doi\/10.1136\/hrt.81.4.412"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1999,4,1]]},"references-count":38,"journal-issue":{"issue":"4","published-online":{"date-parts":[[1999,4,1]]},"published-print":{"date-parts":[[1999,4,1]]}},"alternative-id":["10.1136\/hrt.81.4.412"],"URL":"https:\/\/doi.org\/10.1136\/hrt.81.4.412","relation":{},"ISSN":["1355-6037","1468-201X"],"issn-type":[{"type":"print","value":"1355-6037"},{"type":"electronic","value":"1468-201X"}],"subject":[],"published":{"date-parts":[[1999,4,1]]}}}