A glomerular filtration rate above 60 ml/min during index hospitalization was associated with a significantly higher risk of requiring long-term permanent pacemaker implantation (HR 3.00) compared to a GFR below 30 ml/min.
Cross-Sectional (n=177)
No
Does a GFR >60 ml/min predict the need for permanent pacemaker implantation in the long-term follow-up of patients with drug-related AV block?
In patients with drug-related AV block who do not require a pacemaker initially, a normal GFR (>60 ml/min) paradoxically predicts a higher need for long-term permanent pacemaker implantation, likely reflecting underlying conduction system disease rather than transient drug accumulation.
Estimación del efecto: HR 3.00 (95% CI 1.42-12.10)
Tasa de eventos absoluta: 41.3% vs 13.6%
valor p: p=0.003
BACKGROUND: Most of the patients hospitalized due to drug-related atrioventricular (AV) block do not require permanent pacemaker implantation (PPI) since AV block regresses following cessation of the responsible drug. However, AV block requiring PPI may relapse in long-term follow-up. In this study, we retrospectively evaluated the factors predicting the need for a PPI in the long-term follow-up in patients admitted to our hospital with drug-related AV block but did not require PPI in index hospitalization. RESULTS: We evaluated 177 patients who had been hospitalized with drug-related AV block between January 2012 and July 2020 and who had not required PPI during hospital follow-up. The patients were divided into two groups according to whether PPI was performed or not. The independent predictors of long-term PPI were evaluated and the effect of glomerular filtration rate (GFR) of the patients during the index hospitalization on the long-term outcome was compared. A GFR above 60 ml/min is an independent significant risk factor in predicting long-term permanent pacemaker implantation in drug-related AV blocks. It is found that the need for PPI was 2.64 times higher without adjusted and 1.9 times higher with adjusted for all covariates in patients with GFR above 60 ml/min during hospitalization compared to those with GFR below 30 ml/min. CONCLUSIONS: GFR may be considered as an indicator of the PPI need in patients with drug-related atrioventricular AV block.
Parsova et al. (Mon,) conducted a cross-sectional in Drug-related atrioventricular block (n=177). Glomerular filtration rate > 60 ml/min vs. Glomerular filtration rate < 30 ml/min was evaluated on Long-term permanent pacemaker implantation (HR 3.00, 95% CI 1.42-12.10, p=0.003). A glomerular filtration rate above 60 ml/min during index hospitalization was associated with a significantly higher risk of requiring long-term permanent pacemaker implantation (HR 3.00) compared to a GFR below 30 ml/min.
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