Key result
Beta-blocker use was an independent risk factor for the development of advanced atrioventricular block in patients with sick sinus syndrome and an implanted pacemaker (OR 9.10).
Cohort (n=50)
Yes
In patients with sick sinus syndrome and a pacemaker, advanced AVB occurs at a rate of 11.7% per year, and beta-blocker use significantly increases this risk.
Answers are grounded in this paper and cite their sources.
AVB risk in SSS pacemakers needs monitoring; leaves open whether SafeR alters progression or requires prospective validation.
BACKGROUND: The incidence of atrioventricular block (AVB) in pacemaker patients with sick sinus syndrome (SSS) is not yet known. The aim of this study was to analyze AVB episodes in SafeR mode based on stored electrograms (EGM), and determine the occurrence rate and risk factors for advanced AVB in a pacemaker population with SSS. METHODS AND RESULTS: The study included 50 consecutive patients with SSS without a history of advanced AVB who had a dual-chamber pacemaker programmed in SafeR mode. A total of 377 EGM stored in the pacemakers as AVB episodes fulfilling the second- or third-degree criterion were analyzed. Of 377 EGM, 73 EGM (19.4%) were appropriate episodes, whereas the other EGM did not show actual AVB, and showed atrial tachyarrhythmia, ventricular event in the blanking period, or premature atrial contractions with block. On EGM analysis, advanced AVB occurred in 9 patients (18%), and the occurrence rate was 11.7% per year. Moreover, on multivariate analysis β-blocker use was an independent risk factor for advanced AVB (OR, 9.10; P=0.004). CONCLUSIONS: The occurrence rate of advanced AVB in patients with SSS is much higher than previously reported, and β-blocker use is an independent risk factor for advanced AVB. SafeR is useful to detect latent AVB. Stored EGM, however, sometimes include inaccurately classified events.
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Hosoda et al. (2015) conducted a cohort in Sick sinus syndrome (n=50). β-blocker use vs. No β-blocker use was evaluated on Advanced atrioventricular block (AVB) (OR 9.10, 95% CI 2.01-41.18, p=0.004). Beta-blocker use was an independent risk factor for the development of advanced atrioventricular block in patients with sick sinus syndrome and an implanted pacemaker (OR 9.10).
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