Patients with AV block had a significantly higher incidence of new pacemaker dependency than those with sick sinus syndrome (7.2% vs 2.2%; OR 3.51; 95% CI 1.3-9.3; P=0.012).
Cohort (n=518)
What is the incidence of new onset pacemaker dependency during long-term follow-up after permanent pacemaker implantation in patients with initial intrinsic rhythms?
Patients with AV block are at a significantly higher risk of developing new-onset pacemaker dependency compared to those with sick sinus syndrome after permanent pacemaker implantation.
Odds Ratio: 3.51 (95% CI 1.3–9.3)
Absolute Event Rate: 7.2% vs 2.2%
p-value: p=0.012
Pacemaker dependency has dangerous consequences under conditions of electromagnetic interference, unrecognized lead dysfunction, and battery depletion, and has been associated with cardiovascular and overall mortality. The aim of this study was to examine the incidence of new onset of pacemaker dependency during long-term follow-up after pacing system implantation. The study included 518 patients (mean age 72.9 +/- 10.4 years) who presented with intrinsic rhythms at the time of implantation. Indications for pacing were sick sinus syndrome (SSS) in 275 (53%) patients, AV block in 209 (40%), and AF with bradycardia in 34 (7%) patients. The mean follow-up was 3.7 +/- 2.7 years (range 1-17). Pacemaker dependency was defined as the absence of an intrinsic rhythm during backup pacing at 30 beats/min for 30 seconds. New onset of pacemaker dependency was observed in 23 (4.4%) of the 518 patients at a mean of 3.1 +/- 2.7 years of follow-up. Pacing indications were SSS in 6 (2.2%) of 275 patients, AV block in 15 (7.2%) of 209, and AF with bradycardia in 2 (5.9%) of 34. Patients with AV block had a significantly higher incidence of pacemaker dependency than patients with SSS (odds ratio 3.51; 95% CI 1.3 to 9.3; P = 0.012). The average annual rate of new pacemaker dependency was 1.6% during an 8-year follow-up. The incidence of new onset of pacemaker dependency varied among pacing indications, and was significantly higher in patients with AV block than patients with SSS.
Nagatomo et al. (Thu,) conducted a cohort in Pacemaker implantation (n=518). AV block vs. Sick sinus syndrome (SSS) was evaluated on New onset of pacemaker dependency (OR 3.51, 95% CI 1.3 to 9.3, p=0.012). Patients with AV block had a significantly higher incidence of new pacemaker dependency than those with sick sinus syndrome (7.2% vs 2.2%; OR 3.51; 95% CI 1.3-9.3; P=0.012).