Long-term follow-up of older patients with Mobitz type I second degree atrioventricular block

Abstract

In this retrospective cohort study of older male patients with Mobitz I AV block on ECG, CIED implantation was associated with longer survival.

Mobitz type 1 second degree atrioventricular block: the value of permanent pacing in the older patient

“…The findings reported in this issue by Coumbe et al 1 are firmly in support of European advice for the management of Mobitz 1 AVB. The Minneapolis group was careful to avoid the young and in their selection of patients they omitted Holter data using only 12 lead ECGs.…”

“…Their patients had a high incidence of cardiac comorbidity but when they analysed the subgroup with no evidence of coronary heart disease, heart failure or left ventricular dysfunction, they found that the mortality was 43% versus 65% and that the no-cardiac-comorbidity paced group had a statistically significantly better survival (p<0.028). Coumbe et al 1 point out in their discussion that the published literature on Mobitz type 1 AVB does not support the present North American view on the benign nature of the condition in older people.…”

“…The article by Coumbe et al 1 in this journal is most welcome. It throws more light on a vexed difference between North American and European pacemaker practice, where the two regions’ guidelines for pacemaker implantation differ profoundly 2–4.…”

“…The guidelines’ discrepancy with respect to Mobitz type 1 AVB recommendations prompted Coumbe et al 1 to examine their database to explore this question. Their approach was retrospective as they had a large database available to them of hospital patients in the Veteran's Affairs Healthcare system, and in that regard differed from the studies of Shaw and colleagues,5 6 which were prospective and community based.…”

Application of the Multicenter Automatic Defibrillator Implantation Trial II Risk Score in a Nontrial Setting

“…Mortality was assessed using the Veterans Administration vital status records and social security death index. 4 Data are presented as mean AE 1 SD, percentages, or incidence rates. Comparisons of baseline characteristics of patients in low, intermediate, and high-risk score categories were made using 1-way analysis of variance for continuous variables and chi-square test for categorical variables.…”