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Long‐Term Mortality in Patients with Pauses in Ventricular Electrical Activity
Author(s) -
SABA MAGDI M.,
DONAHUE TIMOTHY P.,
PANOTOPOULOS PANAGIOTIS T.H.,
IBRAHIM SALMA S.,
ABISAMRA FREDDY M.
Publication year - 2005
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.2005.50189.x
Subject(s) - medicine , asymptomatic , cardiology , sinus rhythm , ambulatory , holter monitor , atrial fibrillation , ejection fraction , rhythm , electrocardiography , heart failure
Background: The long‐term significance of ventricular pauses of ≥3.0 seconds observed on Holter monitor is unclear, as previously conducted retrospective studies have been poorly controlled. We compared the prognosis of patients with pauses ≥3.0 seconds on Holter monitor with a well‐matched control group without such pauses.Methods: Scanning the Holter database at Ochsner Clinic (n = 11,730; January 1998 to June 2003) for pauses ≥3.0 seconds identified 70 patients (pause group). Of those, 29 (37.1%) received a permanent pacemaker (PPM group) and 41 (62.9%) did not (No‐PPM group). For each No‐PPM patient, two patients without pauses (<2.0 seconds) exactly matched for age, sex, ejection fraction (EF), rhythm, and duration of follow‐up were randomly chosen from the Holter database (control group, n = 82) and survival of the two groups was compared.Results: Mean age was 72.5 ± 15.0 years, mean EF was 52.2 ± 12.7%, and 68.3% were men. Mean follow‐up was 2.2 years (0.5–4.5 years). There was no difference in survival between the No‐PPM and the control groups (82.9% vs 84.1%, P = NS). Compared with the PPM group, pauses in the No‐PPM group were more commonly asymptomatic, nocturnal, and due to sinus pauses or atrial fibrillation (AF) with slow ventricular response.Conclusions: Pauses in ventricular electrical activity ≥3 seconds on Holter monitor due to sinus pauses or AF with slow ventricular response are not predictive of heightened mortality.