Permanent pacemaker implantation in sick sinus syndrome reduced mortality by 33%, stroke by 56%, and acute coronary syndrome by 51%, but increased heart failure risk (aHR 1.85).
Does permanent pacemaker implantation reduce mortality and cardiovascular events in patients with sick sinus syndrome?
In patients with sick sinus syndrome, permanent pacemaker implantation is associated with significantly reduced risks of mortality, stroke, and acute coronary syndrome, though it may increase the risk of heart failure.
Absolute Event Rate: 0% vs 0%
Abstract Background In patients with sick sinus syndrome (SSS), permanent pacemaker (PPM) implantation relieves their symptoms. It remains unclear if PPM implantation alters the risks of cardiovascular events and mortality. Purpose We aimed to evaluate the impact of PPM implantation in patients with SSS. Methods In this retrospective cohort study, SSS patients were identified from the Taiwan National Health Insurance Research Database during a 10-year period from 2012 to 2021. Patients were divided into two groups based on with or without PPM implantation. They were matched 1:1 for age, gender, and comorbidities. Independent risk factors for outcomes were determined using the multivariate Cox regression model. Results A total of 44,850 propensity score-matched SSS patients were studied, as either the PPM group (n=22,425) or non-PPM group (n=22,425). After follow-up for 9.73±0.01 years, PPM implantation was associated with lower risks of mortality (adjusted hazard ratio (aHR) 0.67, p0.0001), stroke (aHR 0.44, p0.0001), and acute coronary syndrome (aHR 0.49, p0.0001), while with a higher risk of heart failure (aHR 1.85, p=0.02). Dual-chamber PPM implantation was associated with reduced risks of mortality (aHR 0.55, p0.0001), cardiovascular mortality (aHR 0.73, p0.0001), stroke (aHR 0.36, p0.0001), new onset atrial fibrillation (aHR 0.85, p0.001), and acute coronary syndrome (aHR 0.47, p0.0001). The risk of heart failure was again higher (aHR 1.77, p=0.002). Conclusion In patients with SSS, PPM was associated with reduced risks of mortality and cardiovascular events, despite an increased risk of heart failure. We recommend that PPM implantations should be considered for patients with SSS.
Hsieh et al. (Sat,) reported a other. Permanent pacemaker implantation in sick sinus syndrome reduced mortality by 33%, stroke by 56%, and acute coronary syndrome by 51%, but increased heart failure risk (aHR 1.85).
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