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Article: New-onset heart failure after permanent right ventricular apical pacing in patients with acquired high-grade atrioventricular block and normal left ventricular function

TitleNew-onset heart failure after permanent right ventricular apical pacing in patients with acquired high-grade atrioventricular block and normal left ventricular function
Authors
KeywordsAtrioventricular block
Heart failure
Pacing
Right ventricular apex
Issue Date2008
PublisherWiley-Blackwell Publishing, Inc.. The Journal's web site is located at http://www.wiley.com/bw/journal.asp?ref=1045-3873
Citation
Journal Of Cardiovascular Electrophysiology, 2008, v. 19 n. 2, p. 136-141 How to Cite?
AbstractRV Apical Pacing and Heart Failure. Introduction: Emerging data have suggested that right ventricular (RV) apical pacing results in progressive left ventricular (LV) dysfunction and contributes to the development of heart failure (HF). This study aimed to investigate the prevalence and clinical predictors for the development of new-onset HF after long-term RV apical pacing in patients with acquired atrioventricular (AV) block who require permanent pacing. Methods: We studied the clinical outcomes after long-term RV apical pacing for acquired AV block in 304 patients without a prior history of HF. All patients had >90% ventricular pacing as determined by device diagnostic data. Results: After a median follow-up of 7.8 years, 79 patients (26.0%) developed new-onset HF after RV apical pacing. Univariate Cox-regression analysis revealed that older age at the time of pacemaker implantation (P < 0.001), the presence of coronary artery disease (CAD) (P < 0.001) or atrial fibrillation (P = 0.03), VVI pacemaker (P < 0.001), wider paced QRS duration (P < 0.001), and new-onset myocardial infarction (P < 0.001) were predictors for HF. Multivariate analysis revealed that older age at implantation (Hazard ratio [HR] 1.06, 95% confidential interval [CI] 1.04-1.09, P < 0.001), CAD (HR 1.98, 95% CI 1.12-3.50, P < 0.05), and a wider paced QRS duration (HR 1.27 for each 10 ms increment, 95% CI 1.11-1.45, P = 0.001) were independent predictors of HF. Furthermore, cardiovascular mortality was significantly increased in those with HF (36.7% vs. 2.7%, P < 0.001). Conclusions: After a median follow-up of 7.8 years, permanent RV apical pacing was associated with HF in 26% of patients. Elderly age at the time of implant, a wider paced QRS duration and the presence of CAD independently predicted new-onset HF. More importantly, HF after RV apical pacing was associated with a higher cardiovascular mortality. © 2007 by Futura Publishing Company, Inc.
Persistent Identifierhttp://hdl.handle.net/10722/78250
ISSN
2015 Impact Factor: 3.097
2015 SCImago Journal Rankings: 1.863
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorZhang, XHen_HK
dc.contributor.authorChen, Hen_HK
dc.contributor.authorSiu, CWen_HK
dc.contributor.authorYiu, KHen_HK
dc.contributor.authorChan, WSen_HK
dc.contributor.authorLee, KLen_HK
dc.contributor.authorChan, HWen_HK
dc.contributor.authorLee, SWen_HK
dc.contributor.authorFu, GSen_HK
dc.contributor.authorLau, CPen_HK
dc.contributor.authorTse, HFen_HK
dc.date.accessioned2010-09-06T07:40:48Z-
dc.date.available2010-09-06T07:40:48Z-
dc.date.issued2008en_HK
dc.identifier.citationJournal Of Cardiovascular Electrophysiology, 2008, v. 19 n. 2, p. 136-141en_HK
dc.identifier.issn1045-3873en_HK
dc.identifier.urihttp://hdl.handle.net/10722/78250-
dc.description.abstractRV Apical Pacing and Heart Failure. Introduction: Emerging data have suggested that right ventricular (RV) apical pacing results in progressive left ventricular (LV) dysfunction and contributes to the development of heart failure (HF). This study aimed to investigate the prevalence and clinical predictors for the development of new-onset HF after long-term RV apical pacing in patients with acquired atrioventricular (AV) block who require permanent pacing. Methods: We studied the clinical outcomes after long-term RV apical pacing for acquired AV block in 304 patients without a prior history of HF. All patients had >90% ventricular pacing as determined by device diagnostic data. Results: After a median follow-up of 7.8 years, 79 patients (26.0%) developed new-onset HF after RV apical pacing. Univariate Cox-regression analysis revealed that older age at the time of pacemaker implantation (P < 0.001), the presence of coronary artery disease (CAD) (P < 0.001) or atrial fibrillation (P = 0.03), VVI pacemaker (P < 0.001), wider paced QRS duration (P < 0.001), and new-onset myocardial infarction (P < 0.001) were predictors for HF. Multivariate analysis revealed that older age at implantation (Hazard ratio [HR] 1.06, 95% confidential interval [CI] 1.04-1.09, P < 0.001), CAD (HR 1.98, 95% CI 1.12-3.50, P < 0.05), and a wider paced QRS duration (HR 1.27 for each 10 ms increment, 95% CI 1.11-1.45, P = 0.001) were independent predictors of HF. Furthermore, cardiovascular mortality was significantly increased in those with HF (36.7% vs. 2.7%, P < 0.001). Conclusions: After a median follow-up of 7.8 years, permanent RV apical pacing was associated with HF in 26% of patients. Elderly age at the time of implant, a wider paced QRS duration and the presence of CAD independently predicted new-onset HF. More importantly, HF after RV apical pacing was associated with a higher cardiovascular mortality. © 2007 by Futura Publishing Company, Inc.en_HK
dc.languageengen_HK
dc.publisherWiley-Blackwell Publishing, Inc.. The Journal's web site is located at http://www.wiley.com/bw/journal.asp?ref=1045-3873en_HK
dc.relation.ispartofJournal of Cardiovascular Electrophysiologyen_HK
dc.subjectAtrioventricular blocken_HK
dc.subjectHeart failureen_HK
dc.subjectPacingen_HK
dc.subjectRight ventricular apexen_HK
dc.subject.meshAgeden_HK
dc.subject.meshAged, 80 and overen_HK
dc.subject.meshAtrioventricular Block - physiopathology - therapyen_HK
dc.subject.meshCardiac Pacing, Artificial - adverse effects - methodsen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshFollow-Up Studiesen_HK
dc.subject.meshHeart Failure - etiology - physiopathology - therapyen_HK
dc.subject.meshHumansen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshRetrospective Studiesen_HK
dc.subject.meshTime Factorsen_HK
dc.subject.meshVentricular Function, Left - physiologyen_HK
dc.subject.meshVentricular Function, Right - physiologyen_HK
dc.titleNew-onset heart failure after permanent right ventricular apical pacing in patients with acquired high-grade atrioventricular block and normal left ventricular functionen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1045-3873&volume=19&issue=2&spage=136&epage=141&date=2008&atitle=New-onset+heart+failure+after+permanent+right+ventricular+apical+pacing+in+patients+with+acquired+high-grade+atrioventricular+block+and+normal+left+ventricular+function.en_HK
dc.identifier.emailSiu, CW:cwdsiu@hkucc.hku.hken_HK
dc.identifier.emailYiu, KH:khkyiu@hku.hken_HK
dc.identifier.emailTse, HF:hftse@hkucc.hku.hken_HK
dc.identifier.authoritySiu, CW=rp00534en_HK
dc.identifier.authorityYiu, KH=rp01490en_HK
dc.identifier.authorityTse, HF=rp00428en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1111/j.1540-8167.2007.01014.xen_HK
dc.identifier.pmid18005026-
dc.identifier.scopuseid_2-s2.0-38849136492en_HK
dc.identifier.hkuros153475en_HK
dc.identifier.hkuros159752-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-38849136492&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume19en_HK
dc.identifier.issue2en_HK
dc.identifier.spage136en_HK
dc.identifier.epage141en_HK
dc.identifier.isiWOS:000252811000006-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridZhang, XH=16425051500en_HK
dc.identifier.scopusauthoridChen, H=20733607100en_HK
dc.identifier.scopusauthoridSiu, CW=7006550690en_HK
dc.identifier.scopusauthoridYiu, KH=35172267800en_HK
dc.identifier.scopusauthoridChan, WS=13104241000en_HK
dc.identifier.scopusauthoridLee, KL=7501505962en_HK
dc.identifier.scopusauthoridChan, HW=7403402419en_HK
dc.identifier.scopusauthoridLee, SW=27169452400en_HK
dc.identifier.scopusauthoridFu, GS=7202722319en_HK
dc.identifier.scopusauthoridLau, CP=7401968501en_HK
dc.identifier.scopusauthoridTse, HF=7006070805en_HK
dc.identifier.citeulike2325919-

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