Stroke and pacing mode: is pacing mode important?

inus node disease, atrioventricular conduction disease, atrial brillation, and stroke all have markedly increased incidence in he elderly. Thus, there is frequently an overlap of these onditions. Many patients with pacemakers develop atrial brillation (1–3), and many patients with atrial fibrillation have oncomitant sinus node dysfunction and receive pacemakers. his is not surprising in that the sinus node is within the right trium and is prone to the same pathologic processes as the tria. Pathologic changes of the atria are the same in settings of dvanced aging, sinus node dysfunction, and atrial fibrillation, emonstrating an increase in fibrosis and fat deposition, articularly in the approaches to the sinus and atrioventricular odes (4). Because of the high incidence of atrial fibrillation nd other comorbid conditions of the elderly, such as diabetes, ypertension, and great vessel atherosclerosis, patients with acemakers would be expected to have a high incidence of troke.