| Autor: |
Zak, Loring, Anna, Giczewska, Paul, Hofmann, Karen, Chiswell, Todd T, Schlegel, Martin, Ugander, Kevin P, Jackson, Jonathan P, Piccini, Brett D, Atwater |
| Rok vydání: |
2023 |
| Předmět: |
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| Zdroj: |
Journal of Electrocardiology. 77:17-22 |
| ISSN: |
0022-0736 |
| Popis: |
Chronic right ventricular (RV) pacing can induce left ventricular (LV) dyssynchrony and cause pacemaker induced cardiomyopathy (PiCM). Identifying which patients are at risk for PiCM is limited.Patients receiving RV-only permanent pacemakers (PPMs) at Duke University Medical Center between 2011 and 2017 who had normal baseline ejection fractions (EFs) were identified. Patients who developed a subsequent decrease in EF, died, or underwent cardiac resynchronization therapy, left ventricular assist device, or heart transplant without a competing cause were considered as the primary endpoint. Pre-PPM and post-PPM electrocardiograms (ECGs) were analyzed to extract scalar measurements including the lead one ratio (LOR) as well as advanced-ECG (A-ECG) features to identify predictors of PiCM. Traditional and penalized Cox regression were used to identify variables predictive of the primary endpoint.Pre-PPM ECGs were evaluated for 404 patients of whom 140 (35%) experienced the primary endpoint. Predictors included female sex (hazard ratio [HR] 1.14), a T' wave in V6 (HR 1.31), a P' wave in aVL (HR 0.88), and estimated glomerular filtration rate (HR 0.88). Post-PPM ECGs were evaluated for 228 patients for whom 94 (41%) experienced the primary endpoint. Predictors included female sex (HR 0.50), age (HR 1.06), and a history of congestive heart failure (HR 1.63). Neither LOR nor A-ECG parameters were strong predictors of the primary endpoint.Baseline and paced ECG data provide limited insight into which patients are at high risk for developing PiCM. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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Full Text from ScienceDirect