Association of selected factors with long-term prognosis and mortality after dual-chamber pacemaker implant

Dębski, Maciej; Ulman, Mateusz; Ząbek, Andrzej; Boczar, Krzysztof; Haberka, Kazimierz; Kuniewicz, Marcin; Lelakowski, Jacek; Małecka, Barbara

doi:10.5603/cj.a2018.0093

Cited by 6 publications

(7 citation statements)

References 27 publications

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“…3,7 Patients with incident AF had a 3.5-fold higher risk of death compared with those without AF according to Magnussen et al 5 Interestingly, in our previous analysis on the association between baseline factors and long -term mortality, we did not find significantly increased mortality in patients with a DDD PPM and preimplant AF compared with patients without history of AF at baseline. 9 On the other hand, in the present study, we confirmed that permanent AF was associated with unfavorable outcomes in terms of long -term survival. Our results are in line with the analysis by Polewczyk et al 41 who showed that permanent AF was associated with significantly higher mortality following transvenous lead extraction in the mean follow -up of 3.7 years.…”

Section: Risk Factors For Permanent Atrial Fibrillationsupporting

confidence: 83%

“…[3][4][5][6][7][8] Of note, in our recent study, we demonstrated that preimplant AF was not associated with reduced survival in consecutive recipients of dual -chamber (DDD) permanent pacemaker (PPM). 9 A retrospective analysis of patients implanted with modern DDD PPM capable of storing AF data showed that AF burden was not INTRODUCTION Atrial fibrillation (AF) is the most commonly encountered arrhythmia in the population and has been referred to as "epidemic" affecting approximately 3% of adults. 1 AF is considered to be a progressive arrhythmia.…”

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confidence: 99%

“…The survival and lead -related complications in the present cohort have been studied previously. 9,14,15 The endpoints were the onset of permanent AF and all--cause mortality. The data used in the analysis included 1) patients' demographic baseline characteristics: age at implantation and sex; 2) index arrhythmia (primary electrocardiographic pacing indication): atrioventricular block (AVB) or sick sinus syndrome (SSS); 3) a history of AF prior to DDD PPM implantation; 4) position of the RV lead: apical or nonapical at discharge from the department; 5) time of permanent AF onset; and 6) date of death declared in the death certificate.…”

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confidence: 99%

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Permanent atrial fibrillation in patients with a dual‑chamber pacemaker

Dębski¹,

Ulman²,

Ząbek³

et al. 2019

Kardiol Pol

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BACKGROUND Atrial fibrillation (AF) is thought to be a progressive arrhythmia. The impact of sex and position of right ventricular lead is not well recognized. Whilst nonparoxysmal AF compared with paroxysmal AF has been associated with increased mortality in the general population, its prognostic significance in patients with a dual -chamber (DDD) pacemaker is less clear. AIMS The aim of the study was to determine the incidence of permanent AF in patients with a DDD pacemaker, analyze the effect of selected baseline characteristics on permanent AF development, and examine the impact of permanent AF on patient survival. METHODS A retrospective cohort study included 3932 consecutive patients who underwent DDD pacing system implantation between 1984 and 2014. Follow -up was completed in August 2016. We included 3771 patients (96%) with post -operative follow -up and known vital status. Occurrence of permanent AF and all -cause mortality were the study endpoints. RESULTS During mean follow -up of 6.5 years, permanent AF occurred in 717 patients (19%). Sex (hazard ratio [HR], 1.316; 95% CI, 1.134-1.528, for men), age at implant (HR, 1.041; 95% CI, 1.033-1.049, 1-year increase), history of AF (HR, 3.521; 95% CI, 3.002-4.128) were independently associated with permanent AF development, whereas position of right ventricular lead (apical versus nonapical) and primary pacing indication (atrioventricular block versus sick sinus syndrome) were not related to permanent AF. Permanent AF was a significant risk factor for increased mortality (age-and sex -adjusted HR, 1.475; 95% CI, 1.294-1.682). CONCLUSIONS Permanent AF occurrence was independently predicted by advanced age at implant, male sex, and preexisting AF and associated with worse survival.

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Section: Risk Factors For Permanent Atrial Fibrillationsupporting

confidence: 83%

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confidence: 99%

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confidence: 99%

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Permanent atrial fibrillation in patients with a dual‑chamber pacemaker

Dębski¹,

Ulman²,

Ząbek³

et al. 2019

Kardiol Pol

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“…Noteworthy, in a previous study, we showed that compared with the general population, the observed survival of dual -chamber (DDD) pacemaker recipients was significantly inferior until 12 years post implant, while after 12 years of follow -up, the observed survival was significantly higher. 2 Death rates alone do not provide a complete picture of the burden that deaths impose on the population. Another useful measure, which has been gaining increasing popularity in epidemiological reports, INTRODUCTION As shown in the FOLLOW--PACE study by Udo et al, 1 pacemakers implanted for slow heart rhythm restore life expectancy to normal levels.…”

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confidence: 99%

“…Detailed methods of data collection and the baseline characteristics of the study population were presented previously. 2,4 The inclusion criteria were residence status in Małopolska Province at the time of the last pacemaker follow--up visit and death between January 1, 1999, and December 31, 2015. Małopolska Province came into being on January 1, 1999.…”

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confidence: 99%

Years of life lost as a measure of premature death among dual‑chamber pacemaker recipients from Małopolska Province

Dębski¹,

Maniecka-Bryła²,

Dziankowska-Zaborszczyk³

et al. 2019

Kardiol Pol

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BACKGROUND Pacemakers have become the standard of care in patients with severe bradycardia and conduction abnormalities. The survival and premature mortality can be assessed using the years of life lost (YLLs). AIMS The aim of the study was to analyze mortality trends over the period from 1999 to 2015 among patients implanted with a dual-chamber (DDD) pacemaker who were inhabitants of Małopolska Province. METHODS This was a retrospective study of records collected from consecutive patients who underwent de novo DDD pacemaker implantation at a single center between 1984 and 2014. Inclusion criteria were residence status in Małopolska Province at the latest follow-up visit and death between 1999 and 2015. The standard expected years of life lost per death was used to calculate YLLs. Time trends were evaluated with joinpoint models and presented as an average annual percentage change (AAPC). RESULTS Among a total of 3932 consecutive patients implanted with a DDD pacemaker, 1211 patients met the inclusion criteria. We noted an increase in the mean age at implant from 70 years in 1999 to 75.5 years in 2015 (AAPC, 0.6%; P <0.05), the number of years lived after DDD pacemaker implantation from 2.6 years to 8.2 years (AAPC, 7.4%; P <0.05), and the mean age at death from 72.6 years to 83.8 years (AAPC, 0.89%; P <0.05). Finally, we observed a reduction of the YLLs per death from 17.4 years in 1999 to 9 years in 2015 (AAPC,-4%; P <0.05). All trends were significant for both men and women. CONCLUSIONS In the 17-year follow-up, we showed significant changes in analyzed trends, in particular a reduction in the YLLs per death.

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Long-Term Implications of Pacemaker Insertion in Younger Adults: A Single Centre Experience

Shirwaiker

William

Mariani

et al. 2022

Heart, Lung and Circulation

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Association of selected factors with long-term prognosis and mortality after dual-chamber pacemaker implant

Abstract: In the very-long-term follow-up of DDD pacemaker patients, the parameters associated with survival were sex and baseline age at first implantation.

Cited by 6 publications

References 27 publications

Permanent atrial fibrillation in patients with a dual‑chamber pacemaker

Permanent atrial fibrillation in patients with a dual‑chamber pacemaker

Years of life lost as a measure of premature death among dual‑chamber pacemaker recipients from Małopolska Province

Long-Term Implications of Pacemaker Insertion in Younger Adults: A Single Centre Experience

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