Risk factors of pacing dependence and cardiac dysfunction in patients with permanent pacemaker implantation

Yu, Ziqing; Liang, Yixiu; Xiao, Zilong; Wang, Yucheng; Bao, Pei; Zhang, Chunyu; Su, Enyong; Li, Minghui; Chen, Xueying; Qin, Shengmei; Chen, Ruizhen; Su, Yangang; Ge, Junbo

doi:10.1002/ehf2.13918

Cited by 4 publications

(4 citation statements)

References 34 publications

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“…Several previous investigators [ 1 – 14 ], including the authors’ previous report [ 2 ], found a significant association between pacemaker dependency in patients with CIED and second or third degree AV block at implant, age, male gender and heart failure severity as indexed by a higher NYHA functional class, reduced left ventricular ejection fraction and elevated brain natriuretic peptide. In addition, a twofold risk for pacemaker dependency in patients with CIED and chronic kidney disease compared to patients without chronic kidney disease was found [ 2 ].…”

Section: Discussionmentioning

confidence: 97%

“…Although several previous [ 1 – 14 ] studies investigated the prevalence of pacing dependency following implantation of cardiovascular implantable electronic devices (CIEDs), only two previous studies [ 9 , 11 ] determined the prognostic significance of pacing dependency during follow-up. The results of these two previous studies [ 9 , 11 ], however, remained inconclusive.…”

Section: Introductionmentioning

confidence: 99%

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Prognosis of pacing-dependent patients with cardiovascular implantable electronic devices

Grimm,

Erdmann,

Grimm

et al. 2024

Herzschr Elektrophys

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Background Data on the prognostic significance of pacing dependency in patients with cardiovascular implantable electronic devices (CIEDs) are sparse. Methods The prognostic significance of pacing dependency defined as absence of an intrinsic rhythm ≥ 30 bpm was determined in 786 patients with CIEDs at the authors’ institution using univariate and multivariate regression analysis to identify predictors of all-cause mortality. Results During 49 months median follow-up, death occurred in 63 of 130 patients with pacing dependency compared to 241 of 656 patients without pacing dependency (48% versus 37%, hazard ratio [HR] 1.34; 95% confidence interval [CI]: 1.02–1.78, P = 0.04). Using multivariate regression analysis, predictors of all-cause mortality included age (HR 1.07; 95% CI: 1.05–1.08, P < 0.01), history of atrial fibrillation (HR 1.32, 95% CI: 1.03–1.69, P < 0.01), chronic kidney disease (HR 1.28; 95% CI: 1.00–1.63, P = 0.048) and New York Heart Association (NYHA) class ≥ III (HR 2.00; 95% CI: 1.52–2.62, P < 0.01), but not pacing dependency (HR 1.15; 95% CI: 0.86–1.54, P = 0.35). Conclusions In contrast to age, atrial fibrillation, chronic kidney disease and heart failure severity as indexed by NYHA functional class III or IV, pacing dependency does not appear to be an independent predictor of all-cause mortality in patients with CIEDs.

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Prognosis of pacing-dependent patients with cardiovascular implantable electronic devices

Grimm,

Erdmann,

Grimm

et al. 2024

Herzschr Elektrophys

View full text Add to dashboard Cite

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“…To address these issues, pacing techniques involving the His bundle or the left bundle area have recently been introduced [ 4 , 5 ]. Many studies have compared the outcomes of these novel pacing techniques with those of conventional RVP [ 6 ] and investigated the factors contributing to the problems associated with RVP, with pacing rate and QRS duration reported as problematic factors [ 7 , 8 ]. However, to the best of our knowledge, studies of the relationship between RVP and mortality are limited.…”

Section: Introductionmentioning

confidence: 99%

Clinical value of the fibrosis-4 index in predicting mortality in patients with right ventricular pacing

Inoue,

Morikawa,

Ogane

et al. 2024

PLoS ONE

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Background The fibrosis-4 (FIB-4) index has attracted attention as a predictive factor for cardiovascular events and mortality in patients with heart disease. However, its clinical value in patients with implanted pacemakers remains unclear. Methods This study included patients who underwent pacemaker implantation. The FIB-4 index was calculated based on blood tests performed during the procedure. The primary outcome was all-cause mortality, and the secondary outcomes included cardiovascular death, non-cardiovascular death, and major adverse cardiovascular events (MACE; composite of cardiovascular death, heart failure hospitalization, non-fatal myocardial infarction, and non-fatal stroke). The FIB-4 index was stratified into tertiles. Between-group comparisons were performed using log-rank tests and multivariate analysis using Cox proportional hazards. The predictive accuracy and cut-off value of the FIB-4 index were calculated from the receiver operating characteristic curve for all-cause mortality. Finally, based on the calculated cut-off values, the patients were divided into two groups for outcome validation and subgroup analysis. Results This study included 201 participants, of whom 38 experienced death during the observation period (median: 1097 days). All-cause mortality, non-cardiovascular death, and MACE differed significantly between groups stratified by the FIB-4 index tertiles (log-rank test: P<0.001, P<0.001, and P = 0.045, respectively). Using Cox proportional hazards analysis, the unadjusted hazard ratio was 4.75 (95% confidence interval [CI]: 2.05–11.0, P<0.001) for Tertile 3 compared to Tertile 1. After adjustment for confounding factors, including sex, the presence or absence of left bundle branch block at baseline, QRS duration during pacing, and pacing rate at the last check, the hazard ratio was 4.79 (95% CI: 2.04–11.2, P<0.001). The cut-off value of the FIB-4 index was 3.75 (area under the curve: 0.72, 95% CI: 0.62–0.82). Conclusions In patients with pacemakers, the FIB-4 index may be a predictor of early all-cause mortality, with a cut-off value of 3.75.

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“…To address these issues, pacing techniques involving the His bundle or left bundle area have been recently introduced [4,5]. Many studies have compared the outcomes of these novel pacing techniques with those of conventional RVP [6], and investigated the factors contributing to the problems associated with RVP, with pacing rate and QRS duration reported as problematic factors [7,8]. However, to the best of our knowledge, studies on the relationship between RVP and mortality are limited.…”

Section: Introductionmentioning

confidence: 99%

Clinical value of the fibrosis-4 index in predicting mortality in patients with right ventricular pacing

Inoue,

Morikawa,

Ogane

et al. 2023

Preprint

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BackgroundThe fibrosis-4 (FIB-4) index has attracted attention as a predictive factor for cardiovascular events and mortality in patients with heart disease. However, its clinical value in patients with implanted pacemakers remains unclear.MethodsThis study included patients who underwent pacemaker implantation. The FIB-4 index was calculated based on blood tests performed during the procedure. The primary outcome was all-cause mortality, and secondary outcomes included cardiovascular and non-cardiovascular death. The FIB-4 index was stratified into tertiles. Between-group comparisons were performed using log-rank tests and multivariate analysis using Cox proportional hazards. The predictive accuracy and cut-off value of the FIB-4 index were calculated from the receiver operating characteristic curve for all-cause mortality.ResultsThis study included 201 participants, of whom 38 (incidence rate: 5.8/100 person-years) experienced death events during the observation period (median: 1097 days). All-cause and non-cardiovascular death differed significantly between groups stratified by the FIB-4 index tertiles (log-rank test:P<0.001 andP<0.001, respectively). Using Cox proportional hazards analysis, the unadjusted hazard ratio was 4.75 (95% confidence interval [CI]: 2.05–11.0,P<0.001) for Tertile 3 compared to Tertile 1. After adjustment for confounding factors, including age, sex, the presence or absence of left bundle branch block at baseline, QRS duration during pacing, and pacing rate at the last check, the hazard ratio was 3.61 (95% CI: 1.37–9.48,P=0.009). The cut-off of the FIB-4 index was 3.75 (area under the curve: 0.72, 95% CI: 0.62–0.82).ConclusionsThe FIB-4 index was a potential predictive factor for all-cause mortality in patients with implanted pacemakers.

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Risk factors of pacing dependence and cardiac dysfunction in patients with permanent pacemaker implantation

Cited by 4 publications

References 34 publications

Prognosis of pacing-dependent patients with cardiovascular implantable electronic devices

Prognosis of pacing-dependent patients with cardiovascular implantable electronic devices

Clinical value of the fibrosis-4 index in predicting mortality in patients with right ventricular pacing

Clinical value of the fibrosis-4 index in predicting mortality in patients with right ventricular pacing

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