Key result
Male sex, older age, heart failure, and diabetes are linked to higher 10-year pacemaker mortality.
Why the study?
Improving pacing technology justifies regular reevaluation of survival and clinical factors influencing mortality in patients with pacemakers.
Cohort (n=2,939)
No
Answers are grounded in this paper and cite their sources.
In a large single-center cohort of pacemaker patients, long-term survival is independently driven by patient demographics and comorbidities (age, male sex, heart failure, diabetes, and treated hyperlipidemia) rather than index arrhythmia or dual- versus single-chamber device selection.
Background: Improving pacing technology justifies regular reevaluation of survival and influencing factors in patients with pacemakers (PM). Purpose: The aim of this study was to investigate clinical factors with possible impact on survival in PM patients. Methods: This retrospective study is based on PM patients of the Department of Cardiology between 2000 and 2015. In total, 2939 patients with completed 10-year follow-up or death within 10 years were included in a multivariate COX regression. 10-year follow-up period started with patients' first PM implantation. Results: As indicated in the figure, independent risk factors for mortality in PM patients were male sex (P<0.001), higher age at first PM implantation (P<0.001), symptoms of heart failure (P<0.001) or diabetes (P=0.001). Treated hyperlipidemia was identified as a beneficial factor for survival (P=0.002), most probably due to intensive primary and secondary prevention of cardiovascular diseases. Index arrhythmia (indication for PM implantation) did not affect mortality. Implantation of dual chamber PM was not associated with better survival outcome compared to single chamber PM, although a borderline significance was found (P=0.07).
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Riesenhuber et al. (2018) conducted a cohort in Pacemaker patients (n=2,939). Clinical factors (male sex, age, heart failure symptoms, diabetes, treated hyperlipidemia, dual-chamber vs single-chamber pacemaker) vs. Absence of risk factors or single-chamber pacemaker was evaluated on 10-year mortality / survival (p=<0.001). Male sex, older age, heart failure symptoms (all P<0.001), and diabetes (P=0.001) increased 10-year mortality in pacemaker patients, while treated hyperlipidemia improved survival (P=0.002).
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