Premium
Trends of Temporary Pacemaker Implant and Underlying Disease Substrate
Author(s) -
JOU YULAN,
HSU HONGPIN,
TUAN TACHUAN,
WANG KANGLING,
LIN YENNJIANG,
LO LIWEI,
HU YUFENG,
KONG CHIWOON,
CHANG SHIHLIN,
CHEN SHIHANN
Publication year - 2010
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.1540-8159.2010.02893.x
Subject(s) - medicine , etiology , incidence (geometry) , implant , demographics , cardiology , odds ratio , disease , coronary artery disease , surgery , physics , demography , sociology , optics
Background: To evaluate contemporary trends of clinical characteristics, etiologies, and underlying diseases, and their relationship between different bradyarrhythmias in patients undergoing temporary pacemakers (TPMs) .Methods: This study included 509 patients (77 ± 11 year, 74% males) with symptomatic bradyarrhythmias requiring TPMs between 2002 and 2008. Demographics, electrocardiographic indications, etiologies, underlying diseases, and the outcome of permanent pacemaker (PPM) implants within 30 days were analyzed.Results: Atrioventricular conduction dysfunction (AVCD) (64.0%) dominated in all bradyarrhythmias, with idiopathic degeneration (61%) as its major etiology. Antiarrhythmic drug (38%) was the leading cause in sinoatrial node dysfunction (SAND). There was an increasing trend in AVCD, while a decreasing trend in SAND. Regarding etiologies for TPM, an increasing trend was found in idiopathic degeneration, whereas a decreasing trend in acute coronary syndrome (ACS). Idiopathic degeneration had an odds ratio (OR) of 1.9 for AVCD (P = 0.001), whereas electrolyte/acid‐base disturbances (OR = 3.7, P = 0.001), β‐blockers (OR = 2.4, P = 0.002), and chronic renal disease (OR = 1.9, P = 0.01) were associated with SAND. Patients with intrinsic etiologies for TPM had a high incidence of PPM implantation within 30 days than those with extrinsic causes (67.5% vs 3.8%, P < 0.0001)Conclusion: Increasing trends in patients requiring TPMs were observed in the elderly patients and those with AVCD and idiopathic degeneration, while decreasing trends were observed in those with SAND and ACS. Idiopathic degeneration was associated with AVCD, whereas extrinsic etiologies were related to SAND. Patients with intrinsic etiologies had a higher incidence of PPM implantation than those with extrinsic factors for TPM. (PACE 2010; 33:1475–1484)