Schietinger BJ, Brammer GM, Wang H, Christopher JM, Kwon KW, Mangrum AJ, Mangrum JM, Kramer CM. Paton MF, Gierula J, Lowry JE, Cairns DA, Bose Rosling K, Cole CA, McGinlay M, Straw S, Byrom R, Cubbon RM, Kearney MT, Witte KK. The https:// ensures that you are connecting to the The risk of HF increases with age in the general population; therefore, it is not a surprising observation that with increasing age, the risk of HF increased among patients with PM. G.S. The .gov means its official. The main study endpoint was HF or fatal HF within the first 2years of follow-up from the date of inclusion in both PM and control groups. The corresponding risk of HF were 9.0% (patients with SSS) and 11.3% (among patients with advanced AV block). Acute MI is one of the major causes of HF; hence, it is included as a competing risk. 2021 Dec 13;16(12):e0259450. For full access to this pdf, sign in to an existing account, or purchase an annual subscription. 2021 Feb;8(1):222-237. doi: 10.1002/ehf2.13144. The NPR is described previously, and diagnosis codes used have a very high positive predictive value.16,17 The NPR was used to define selected comorbidities [hypertension, diabetes, chronic kidney disease (CKD), prior myocardial infarction (MI), ischaemic heart disease, chronic obstructive pulmonary disease, and atrial fibrillation (AF)] based on these diagnosis codes. Developing a global practice-based framework of person-centred care from primary data: a cross-national qualitative study with patients, caregivers and healthcare professionals. Detrimental Immediate- and Medium-Term Clinical Effects of Right Ventricular Pacing in Patients With Myocardial Fibrosis. Outcome was the cumulative incidence of HF including fatal HF within the first 2years of PM implantation, with all-cause mortality and myocardial infarction (MI) as competing risks. Zhuo W, Zhong X, Liu H, Yu J, Chen Q, Hu J, Xiong Q, Hong K. Front Cardiovasc Med. Chan JY, Fang F, Zhang Q, Fung JW, Razali O, Azlan H, Lam KH, Chan HC, Yu CM. In comparison to RVP devices, CRT devices are shown to be beneficial in patients with HF and LVEF of 35% in whom a PM is required due to advanced AV block.2 In fact, the 2016 European guideline for HF has incorporated CRT as the device of choice for ventricular pacing in cases of advanced AV block and HF.25 However, among patients with normal LVEF, the evidence is limited in randomized settings.26 Although a more than 10% risk of HF is substantial, it is far from where a generalized recommendation of a de novo implantation of CRT can be made for all patients with bradycardia and normal EF. Pacemaker with an RVP lead is strongly associated with risk of HF specifically within the first 6months. Forest plot showing the factors associated with risk of heart failure among patients with right ventricular pacing. All other authors declared no conflict of interest. The study was approved by the Danish Data Protection Agency (2007-58-0015, GEH-2014015, I-Suite-nr 02733). Front Cardiovasc Med. 2019 Nov 21;40(44):3649-3650. doi: 10.1093/eurheartj/ehz715. Restoration of electromechanical dyssynchrony and LV function by upgrading to CRT in pacing induced cardiomyopathy patients would have further established that the HF is caused by the abnormal activation caused by RVP.11,30 It is beyond the scope of the current study to understand the impact of CRT upgrade in pacing induced cardiomyopathy patients due to limitation of the study design. Risks for the three time-intervals were <30days [hazard ratio (HR) 5.98, 95% CI 5.196.90], 30180days (HR 1.84, 95% CI 1.711.98), and >180days (HR 1.11, 95% CI 1.041.17). Finally, patients with PM and controls differed significantly with higher burden of comorbidities among patients with PM. Among patients with a PM device, factors associated with increased risk of HF were male sex (HR 1.33, 95% CI 1.24-1.43), presence of chronic kidney disease (CKD) (HR 1.64, 95% CI 1.29-2.09), and prior MI (1.77, 95% 1.50-2.09). Transplant Infectious Disease Physician Faculty Positions, Infectious Diseases Translational Investigator, Cancer Epidemiology & Associate Director of Community Outreach and Engagement, Copyright 2022 European Society of Cardiology. The National Patient Registry (NPR) holds information about every inpatient and outpatient contact.

2022 Mar 22;9:849143. doi: 10.3389/fcvm.2022.849143. Epub 2007 Nov 12. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide, This PDF is available to Subscribers Only. The incidence of HF among the patients with VVI was 16% and among patients with DDD was 9%. Careers. Among patients with PM, 6512 (23.5%) were implanted with a single RV lead device (VVI) and 21192 (76.5%) were implanted with a dual chamber device (DDD). Clinical Outcomes in Patients With Left Bundle Branch Area Pacing vs. Zhang XH, Chen H, Siu CW, Yiu KH, Chan WS, Lee KL, Chan HW, Lee SW, Fu GS, Lau CP, Tse HF. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (, Resounding victory in golf of the Continental Europe Team of Cardiology, Pharmacogenetics-guided dalcetrapib therapy after an acute coronary syndrome: the dal-GenE trial, Novel technique of sutureless pulmonic valve replacement for quadricuspid pulmonic valve with huge pulmonary artery aneurysm, Immunosuppressive therapy in virus-negative inflammatory cardiomyopathy: 20-year follow-up of the TIMIC trial, Heart failure: how to optimize guideline-directed medical therapy, https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model, Receive exclusive offers and updates from Oxford Academic. Careful pre-implant and follow-up evaluations of patient are reasonable in patients with PM and in selected patients, implantation of CRT could be considered instead of an RVP-only device.

Due to violation of proportional hazards, the follow-up period was divided into three time-intervals: <30 days, 30-180 days, and >180 days-2 years. From the current data, we cannot rule out if development of HF is due to impending cardiomyopathy associated with AV block or bradyarrhythmia. 2021 Jul 8;8:685253. doi: 10.3389/fcvm.2021.685253. Prinzen FW, Hunter WC, Wyman BT, McVeigh ER.

This site needs JavaScript to work properly. The adjusted relative risk of HF was significantly higher among patients with advanced AV block (HR 1.25, 95% CI 1.151.35, P<0.0001) in comparison to those with SSS. 2022 Jul 3;11(13):3862. doi: 10.3390/jcm11133862. Mobile Cardiac Acoustic Monitoring System to Evaluate Left Ventricular Systolic Function in Pacemaker Patients. Federal government websites often end in .gov or .mil. This emphasizes the need for evaluation of clinical symptoms and LV function both prior to PM implantation and at follow-up. PMC Although no patients in this study had a His bundle PM, this study has great relevance in the wake of the recent focus on His bundle pacing (HBP) in the international pacing community.27 In contrast the non-physiological, abnormal activation pattern seen with conventional RVP,11 HBP preserves intrinsic physiological activation by activating the ventricles via the His-Purkinje system. Therefore, it remains to be answered, whether patients who were diagnosed with HF after PM implantation and then upgraded to a CRT device had benefit from this treatment. Would you like email updates of new search results? The site is secure. Tel: +45 97 66 44 44, Fax: +45 97 66 44 80, Email: Search for other works by this author on: Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Division of Cardiology, Duke University Medical Center, Department of Medicine, Zealand University Hospital, National Institute of Public Health, University of Southern Denmark, Department of Clinical Investigation and Cardiology, Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Dual-chamber pacing or ventricular backup pacing in patients with an implantable defibrillator: the Dual Chamber and VVI Implantable Defibrillator (DAVID) Trial, Biventricular pacing for atrioventricular block and systolic dysfunction, Adverse effect of ventricular pacing on heart failure and atrial fibrillation among patients with normal baseline QRS duration in a clinical trial of pacemaker therapy for sinus node dysfunction, Biventricular pacing is superior to right ventricular pacing in bradycardia patients with preserved systolic function: 2-year results of the PACE trial, Incidence and predictors of right ventricular pacing-induced cardiomyopathy in patients with complete atrioventricular block and preserved left ventricular systolic function, Incidence and predictors of right ventricular pacing-induced cardiomyopathy, The prevalence of heart failure and asymptomatic left ventricular systolic dysfunction in a typical regional pacemaker population, Left ventricular endocardial activation during right ventricular pacing: effect of underlying heart disease, Mapping of regional myocardial strain and work during ventricular pacing: experimental study using magnetic resonance imaging tagging, Comparative long-term outcomes after cardiac resynchronization therapy in right ventricular paced patients versus native wide left bundle branch block patients, Speckle-tracking radial strain reveals left ventricular dyssynchrony in patients with permanent right ventricular pacing, Long-term impact of right ventricular pacing on left ventricular systolic function in pacemaker recipients with preserved ejection fraction: results from a large single-center registry, Heart failure in patients with sick sinus syndrome treated with single lead atrial or dual-chamber pacing: no association with pacing mode or right ventricular pacing site, Reduction in unnecessary ventricular pacing fails to affect hard clinical outcomes in patients with preserved left ventricular function: a meta-analysis, Positive predictive value of cardiovascular diagnoses in the Danish National Patient Registry: a validation study, Short-term mortality risk of serum potassium levels in hypertension: a retrospective analysis of nationwide registry data, Incidence and time course for developing heart failure with high-burden right ventricular pacing, Left ventricular function during and after right ventricular pacing, Prevalence of dyssynchrony and relation with long-term outcome in patients after acute myocardial infarction, Myocardial regional interstitial fibrosis is associated with left intra-ventricular dyssynchrony in patients with heart failure: a cardiovascular magnetic resonance study, Patterns of late gadolinium enhancement in chronic hemodialysis patients, 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Huang J, Zhang W, Pan C, Zhu S, Mead RH, Li R, He B. J Clin Med. The cumulative incidence was nearly 11% among patients with pacemaker. Incidence and Time Course for Developing Heart Failure With High-Burden Right Ventricular Pacing. Methods and results: Conflict of interest: P.S. The results reflect the main results and are shown in Supplementary material online, Appendix S4. Jena D, Melenovsk V, Stehlik J, Stank V, Kettner J, Kautzner J, Admkov V, Wohlfahrt P. ESC Heart Fail. This nationwide, register-based study demonstrated that there is an increased risk of HF diagnosis among patients with PM particularly during the first 30 and 180days post-implantation. Data management and statistical analyses were performed using SAS version 9.4 and R, version 3.5.0. : speaker for Medtronic and Biosense Webster, Research Grants from Boston Scientific and Abbott Vascular, Advisory Board for Biotronik and Medtronic. Unable to load your collection due to an error, Unable to load your delegates due to an error. The present study has no data on pacing lead position; while evidence so far suggest non-apical RVP to be superior to apical RVP, data are limited to support it and optimal site of RV lead position is yet debatable.29. and transmitted securely. Risk of heart failure- and cardiac death gradually increases with more right ventricular pacing. Although an increased risk of HF was observed among both study groups with increasing time, the relative risk was similar between the period 180days2years and 210years follow-up period (Supplementary material online, Appendix S6). Li X, Zhang J, Qiu C, Wang Z, Li H, Pang K, Yao Y, Liu Z, Xie R, Chen Y, Wu Y, Fan X. Ebert M, Jander N, Minners J, Blum T, Doering M, Bollmann A, Hindricks G, Arentz T, Kalusche D, Richter S. Riahi S, Nielsen JC, Hjortshoj S, Thomsen PE, Hojberg S, Moller M, Dalsgaard D, Nielsen T, Asklund M, Friis EV, Christensen PD, Simonsen EH, Eriksen UH, Jensen GV, Svendsen JH, Toff WD, Healey JS, Andersen HR; DANPACE Investigators. Pacing-induced cardiomyopathy: just the tip of the iceberg? New-onset heart failure after permanent right ventricular apical pacing in patients with acquired high-grade atrioventricular block and normal left ventricular function. Factors associated with risk of HF among PM patients are presented in Figure5. Antoni ML, Boden H, Hoogslag GE, Ewe SH, Auger D, Holman ER, van der Wall EE, Schalij MJ, Bax JJ, Delgado V. Lin LY, Wu CK, Juang JM, Wang YC, Su MY, Lai LP, Hwang JJ, Chiang FT, Tseng WY, Lin JL. Clinical Outcomes of His Bundle Pacing Compared to Right Ventricular Pacing. Increased risk of heart failure was observed among patients with right ventricular pacing until the first 6months. : research grants from the Danish Heart Foundation and Eva & Henry Frnkel Foundation and speakers honoraria from Lundbeck; B.D.A. Circ Cardiovasc Imaging. All rights reserved. Recent advances in the management of pulmonary hypertension with interstitial lung disease. Outcome was the cumulative incidence of HF including fatal HF within the first 2 years of PM implantation, with all-cause mortality and myocardial infarction (MI) as competing risks. : receives lecture fees from Novartis and Sanofi; K.H.K. Patients with antecedent history of MI and CKD had substantially increased risk. Risks for the three time-intervals were <30 days [hazard ratio (HR) 5.98, 95% CI 5.19-6.90], 30-180 days (HR 1.84, 95% CI 1.71-1.98), and >180 days (HR 1.11, 95% CI 1.04-1.17). Abdelrahman M, Subzposh FA, Beer D, Durr B, Naperkowski A, Sun H, Oren JW, Dandamudi G, Vijayaraman P. J Am Coll Cardiol. One of the main limitations of the study is the lack of echocardiographic data prior to or after device implantation to support our findings. Clipboard, Search History, and several other advanced features are temporarily unavailable. Our results are supported by a previous study in which an instantaneous (within 7days) fall of LVEF (mean 10% fall) was observed after an RVP device was implanted in patients with normal LVEF.21 Moreover, experimental studies have also demonstrated an abnormal contraction pattern with redistribution of the myocardial work load within a short duration of pacing.10 However, unmeasured confounding effect cannot be omitted as the patients with PM are sick and the need for pacing rather than pacing itself is the reason that they are at such high early risk (<30days). Atrial fibrillation is likely to be underreported in the current study at baseline because a significant number of patients were implanted a VVI device (23.5%), but AF was reported at baseline in just 4%. Patients with right ventricular pacing have significantly higher risk of heart failure in comparison to patients without pacemaker within the first 6months. Like the main results, the relative risk between the study groups when divided into three time-intervals showed a decreasing risk with increasing time period (Supplementary material online, Appendix S3). The Author(s) 2019. 2015 Apr 15;185:95-100. doi: 10.1016/j.ijcard.2015.03.053. To ensure that the increased risk of HF among patients with PM devices relative to controls were not driven by comorbidity differences, we performed a sensitivity analysis, in which patients with any of the following comorbidities were excluded: hypertension, diabetes, CKD, prior MI, ischaemic heart disease, chronic obstructive pulmonary disease, and AF.

eCollection 2021. reported in a sub-study of the MOST trial that patients with RVP devices with prior MI had a more severe decline in LVEF. For each case, five age- and sex-matched controls were identified (n=138520). For the three follow-up periods, a significantly increased risk of HF was observed among patients with PM in comparison to controls for the first 30days (adjusted HR 5.95, 95% CI 5.166.86, P<0.001) and 30days to 180days interval (adjusted HR 1.83, 95% CI 1.701.97, P<0.001), with a marginally increased risk after 180days (adjusted HR 1.09, 95% CI 1.031.16, P 0.002; Figure2). This revealed a violation of this assumption (P<0.001); hence, time-dependent Cox regression analysis was performed. Personalised reprogramming to prevent progressive pacemaker-related left ventricular dysfunction: A phase II randomised, controlled clinical trial. All-cause mortality was observed among 4460 (16.1%) patients for those with PM and 15178 (11%) among controls, and relative risk of all-cause death between the two groups is reported in Supplementary material online, Appendix S2. Effect of right ventricular pacing lead site on left ventricular function in patients with high-grade atrioventricular block: results of the Protect-Pace study, Long-term clinical effects of ventricular pacing reduction with a changeover mode to minimize ventricular pacing in a general pacemaker population, Atrial antitachycardia pacing and managed ventricular pacing in bradycardia patients with paroxysmal or persistent atrial tachyarrhythmias: the MINERVA randomized multicentre international trial. Pacemaker patients had a higher comorbidity burden, with a higher frequency of hypertension, diabetes, CKD, prior MI, chronic obstructive lung disease, and AF. In Denmark, all residents are provided with a unique personal number making it possible to identify them in national administrative registries.

We further performed a matching analysis where both study groups (PM and control) were matched for age, sex, and history of myocardial infarct at baseline. For each age group, the risk of HF was tested between patients with and without PM. Epub 2018 Mar 10. Forest plot showing the comparative risk of heart failure between patients with right ventricular pacemaker and patients with no pacemaker for the three time-intervals. An age- and gender-matched control cohort (matched 1:5, n = 138 520) without PM and HF was identified to compare the risk. Department of Cardiology, Aalborg University Hospital. Among patients with a PM device, factors associated with increased risk of HF were male sex (HR 1.33, 95% CI 1.241.43), presence of chronic kidney disease (CKD) (HR 1.64, 95% CI 1.292.09), and prior MI (1.77, 95% 1.502.09). Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JG, Coats AJ, Falk V, Gonzalez-Juanatey JR, Harjola VP, Jankowska EA, Jessup M, Linde C, Nihoyannopoulos P, Parissis JT, Pieske B, Riley JP, Rosano GM, Ruilope LM, Ruschitzka F, Rutten FH, van der Meer P; ESC Scientific Document Group. The Author(s) 2019. Moreover, it will help to understand the magnitude of the problem. eCollection 2022. Wilkoff BL, Cook JR, Epstein AE, Greene HL, Hallstrom AP, Hsia H, Kutalek SP, Sharma A; Dual Chamber and VVI Implantable Defibrillator Trial Investigators. The main findings of this large-scale nationwide registry study exploring the risk of incident HF between HF-naive patients with and without PM with an RVP lead can be summarized as follows (Take home figure): There is a more than 10% risk of development of HF at the end of 2years in patients with PM devices which is significantly higher in comparison to general population controls, for whom the risk was around 7%; Although 1- and 6-month risks of HF were significantly elevated in patients with PM devices across all age groups, the longer-term risk (>6months to 2years) of HF was only significantly elevated among younger patients (<60 years); and. Patients who had a diagnosis of HF prior to PM implantation were excluded. : reports research grants from Bayer, Boehringer Ingelheim, Pfizer, Bristol Myers Squibb, and AstraZeneca; C.T.-P.: speaker honoraria and study grants from Bayer and a study grant from Biotronik; L.K. Nevertheless, this study further indicates that if there is a substrate to the development of HF following PM device implantation, it will happen within a short span and if HF is not observed within the first 6months then the likelihood for HF onset is substantially lower beyond 6months post-implantation.

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