Survival Analysis in Patients With Preserved Left Ventricular Function and Standard Indications for Permanent Cardiac Pacing Randomized to Right Ventricular Apical or Septal Outflow Tract Pacing

Autor: Justyna Staniewicz, Ewa Lewicka-Nowak, Rajmund Wilczek, Dariusz Kozłowski, Grzegorz Raczak, Anna Faran, Sebastian Tybura, Paweł Zagożdżon, G. Swiatecka, Alicja Dabrowska-Kugacka
Rok vydání: 2009
Předmět:
Zdroj: Circulation Journal. 73:1812-1819
ISSN: 1347-4820
1346-9843
DOI: 10.1253/circj.cj-09-0084
Popis: Background: Optimal right ventricular (RV) pacing site in patients referred for permanent cardiac pacing remains controversial. A prospective randomized trial was done to compare long-term effect of permanent RV apex (RVA) vs RV outflow tract (RVOT) pacing on the all-cause and cardiovascular mortality. Methods and Results: A total of 122 consecutive patients (70 men, 69 ±11 years), with standard pacing indications were randomized to RVA (66 patients) or RVOT (56 patients) ventricular lead placement. After the 10-year follow-up period the mortality data were summarized on the basis of an intention-to-treat analysis. During the long-term follow-up, 31 patients from the RVA group died vs 24 patients in the RVOT group (hazard ratio (HR), 0.96; 95% confidence interval (CI), 0.57-1.65; P=0.89). There were 10 cardiovascular deaths in the RVA and 12 in the RVOT group (HR, 1.04; 95%CI, 0.45-2.41; P=0.93). There were no differences in the all-cause or cardiovascular mortality between the pacing sites after adjustment for age, gender, arterial hypertension, atrial fibrillation, New York Heart Association class and left ventricular end-diastolic diameter. Conclusions: The RVOT provides no additional benefit in terms of long-term survival over RVA pacing. (Circ J 2009; 73: 1812-1819)
Databáze: OpenAIRE