Key result
Atrioventricular block was associated with higher mortality compared to sick sinus syndrome in patients with permanent pacemakers (P=0.02), especially in those with concurrent coronary heart disease.
Why the study?
Does the underlying conduction disorder (AV block vs SSS) affect mortality in patients treated with permanent pacemakers?
Cohort (n=128)
Does the underlying conduction disorder (AV block vs SSS) affect mortality in patients treated with permanent pacemakers?
p-value: p=0.02
Patients requiring permanent pacing for AV block have higher mortality than those paced for sick sinus syndrome, particularly in the presence of coronary heart disease.
May warrant closer surveillance in paced AV block patients with coronary disease; leaves open whether conduction disorder independently drives mortality.
The prognosis of 64 patients with atrioventricular (AV) block among 128 consecutive patients, 65 males and 63 females, treated with permanent pacemakers, was compared with that of 56 patients with sick sinus syndrome (SSS) during a mean observation period of 32.5 months. A poor survival rate was found in patients with known coronary heart disease (CHD) compared to those with isolated conduction defect (ICD). Among patients with CHD, a higher mortality was found in patients with AV block than in those with SSS (58 vs. 24%). Likewise, among patients with ICD the mortality in AV block was higher than in SSS (31 vs. 15%). Regression analysis showed a mortality excess in AV block vs. SSS (p=0.02), males vs. females (p=0.04). The mortality excess in patients with CHD vs. ICD was significant (p=0.01). It is concluded that the increased mortality rate in patients with AV block is related to widespread myocardial damage, this being especially pronounced in patients with CHD.
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Otterstad et al. (1981) conducted a cohort in Patients treated with permanent pacemakers (n=128). Atrioventricular (AV) block vs. Sick sinus syndrome (SSS) was evaluated on Mortality (p=0.02). Atrioventricular block was associated with higher mortality compared to sick sinus syndrome in patients with permanent pacemakers (P=0.02), especially in those with concurrent coronary heart disease.
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