Key result
Obstructive coronary artery disease (≥50% stenosis) was found in 34.4% of patients undergoing permanent pacemaker implantation for symptomatic bradyarrhythmia.
Why the study?
The cause-effect of conduction disturbance in chronic coronary artery lesions is complicated, prompting evaluation of coexistent CAD in symptomatic bradyarrhythmia to find common anatomic bases and links to conventional risk factors.
What is the prevalence of coexistent coronary artery disease in patients undergoing permanent pacemaker implantation for symptomatic bradyarrhythmia?
Observational (n=929)
What is the prevalence of coexistent coronary artery disease in patients undergoing permanent pacemaker implantation for symptomatic bradyarrhythmia?
Obstructive coronary artery disease is present in approximately one-third of patients undergoing permanent pacemaker implantation for symptomatic bradyarrhythmia, highlighting the potential need for coronary evaluation in those with traditional risk factors.
High CAD prevalence supports risk-factor-guided evaluation in pacemaker candidates; leaves open whether routine screening improves outcomes.
BACKGROUND: The cause-effect of conduction disturbance in chronic lesion of coronary arteries is complicated. This study was designed to evaluate coexistent CAD in patients with symptomatic bradyarrhythmia to find common anatomic basis for conduction disturbances and its relationship to conventional coronary risk factors. METHODS: In this prospective observational study, 929 patients who admitted for symptomatic bradyarrhythmia requiring permanent pacemaker implantation were included. All included patients underwent coronary angiography and were divided into groups based on angiographic findings. Association between conduction disturbances and these groups were analyzed. RESULTS: A total of 929 patients with mean age of 63.1 years were included in our study. We found age ≥50 years, male sex, presence of diabetes and hypertension as statistically significant predictors of abnormal coronary angiography. Obstructive CAD (≥50% stenosis) was found in 34.4% patients. Prevalence of single vessel disease, double vessel disease and triple vessel disease was 15.3%, 10.2% and 8.9% respectively. Severe coronary obstruction (≥90% obstruction) was found in 16.25% patients. Revascularization was advised in three fourth of cases of obstructive CAD. Approximately two third of patients didn't have significant obstruction in coronaries supplying the conduction system. Type 4 was the commonest anatomy in obstructive CAD. SA Nodal artery was found more diseased in patients of SSS with p value of 0.01. CONCLUSION: Obstructive CAD was found in one third of patients undergoing PPI. Age ≥50 years, male sex, diabetes and hypertension were found significantly correlated with presence of CAD and may act as important markers for the judgment of further coronary evaluation.
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Vyas et al. (2021) conducted an observational in Symptomatic bradyarrhythmia (n=929). Conventional coronary risk factors (age ≥50 years, male sex, diabetes, hypertension) was evaluated on Obstructive coronary artery disease (≥50% stenosis). Obstructive coronary artery disease (≥50% stenosis) was found in 34.4% of patients undergoing permanent pacemaker implantation for symptomatic bradyarrhythmia.
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