Bhupendar Tayal1, Patricia Fruelund1, Peter Sogaard1, Sam Riahi1, Christoffer Polcwiartek1,2,3, Brett D Atwater3, Gunnar Gislason4,5,6,7, Niels Risum8, Christian Torp-Pedersen1,8, Lars Kober9, Kristian Hay Kragholm1,2. 1. Department of Cardiology, Aalborg University Hospital, Hobrovej 18-22, Aalborg, Denmark. 2. Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Hobrovej 18-22, Aalborg, Denmark. 3. Division of Cardiology, Duke University Medical Center, Durham, NC, USA. 4. Department of Medicine, Zealand University Hospital, Køge, Denmark. 5. Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark. 6. The Danish Heart Foundation, Copenhagen, Denmark. 7. National Institute of Public Health, University of Southern Denmark, Denmark. 8. Department of Clinical Investigation and Cardiology, Nordsjaellands Hospital, Hillerød, Denmark. 9. Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
Abstract
AIMS: The objective of the current study is to investigate the risk of heart failure (HF) after implantation of a pacemaker (PM) with a right ventricular pacing (RVP) lead in comparison to a matched cohort without a PM and factors associated with this risk. METHODS AND RESULTS: All patients without a known history of HF who had a PM implanted with an RVP lead between 2000 and 2014 (n = 27 704) were identified using Danish nationwide registries. An age- and gender-matched control cohort (matched 1:5, n = 138 520) without PM and HF was identified to compare the risk. 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. 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. The cumulative incidence of HF including fatal HF was observed in 2937 (10.6%) PM patients. 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). 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). CONCLUSIONS: Pacemaker with an RVP lead is strongly associated with risk of HF specifically within the first 6 months. Patients with antecedent history of MI and CKD had substantially increased risk. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: The objective of the current study is to investigate the risk of heart failure (HF) after implantation of a pacemaker (PM) with a right ventricular pacing (RVP) lead in comparison to a matched cohort without a PM and factors associated with this risk. METHODS AND RESULTS: All patients without a known history of HF who had a PM implanted with an RVP lead between 2000 and 2014 (n = 27 704) were identified using Danish nationwide registries. An age- and gender-matched control cohort (matched 1:5, n = 138 520) without PM and HF was identified to compare the risk. 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. 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. The cumulative incidence of HF including fatal HF was observed in 2937 (10.6%) PM patients. 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). 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). CONCLUSIONS: Pacemaker with an RVP lead is strongly associated with risk of HF specifically within the first 6 months. Patients with antecedent history of MI and CKD had substantially increased risk. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Christopher E D Saunderson; Maria F Paton; Louise A E Brown; John Gierula; Pei G Chew; Arka Das; Anshuman Sengupta; Thomas P Craven; Amrit Chowdhary; Aaron Koshy; Hazel White; Eylem Levelt; Erica Dall'Armellina; Pankaj Garg; Klaus K Witte; John P Greenwood; Sven Plein; Peter P Swoboda Journal: Circ Cardiovasc Imaging Date: 2021-05-18 Impact factor: 7.792
Authors: Maria F Paton; John Gierula; Judith E Lowry; David A Cairns; Kieran Bose Rosling; Charlotte A Cole; Melanie McGinlay; Sam Straw; Rowena Byrom; Richard M Cubbon; Mark T Kearney; Klaus K Witte Journal: PLoS One Date: 2021-12-13 Impact factor: 3.240