Document Detail


Death in patients with permanent pacemakers for sick sinus syndrome.
MedLine Citation:
PMID:  14597940     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Although more than one million patients in the United States have permanent pacemakers, little is known about their cause of death. We evaluated the cause of death in 404 patients who died in the Mode Selection Trial (MOST). METHODS: In MOST, patients received a dual-chamber pacemaker randomly programmed to either dual-chamber or ventricular pacing. The circumstances surrounding each death were reviewed by a clinical events committee, which used prospectively defined criteria to adjudicate the cause of death. RESULTS: A total of 2010 patients with a median age of 74 years were included. After a median follow-up of 33 months, 404 (20%) patients died, including 198 (49%) of noncardiac causes and 143 (35.4%) of cardiac causes. In 63 patients, the cause of death was unknown. Independent predictors of death through the use of a multivariable analysis were (1) demographic factors including age, male sex, and weight; (2) clinical factors including prior myocardial infarction, cardiomyopathy, New York Heart Association class III/IV, and the Charlson Comorbidity Index; and (3) scores from two measures of functional status, the Karnofsky Score and the Mini-Mental State Examination. Independent predictors of cardiovascular death were similar. CONCLUSIONS: Patients treated with permanent pacemakers for sinus node dysfunction are elderly and have a substantial mortality rate, with more than half the classifiable deaths being noncardiac. Baseline demographic variables and scores from quality-of-life measures can identify patients with the highest risk of death.
Authors:
Greg Flaker; Arnold Greenspon; Barbara Tardiff; Eleanor Schron; Lee Goldman; Anne Hellkamp; Kerry Lee; Gervasio Lamas;
Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  American heart journal     Volume:  146     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2003 Nov 
Date Detail:
Created Date:  2003-11-04     Completed Date:  2004-02-25     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  887-93     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiology, University of Missouri, Columbia, Columbia, Mo 65212, USA. flakerg@health.missouri.edu
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MeSH Terms
Descriptor/Qualifier:
Age Distribution
Aged
Cardiovascular Diseases / classification,  mortality*
Cause of Death*
Comorbidity
Female
Follow-Up Studies
Humans
Male
Pacemaker, Artificial / statistics & numerical data*
Proportional Hazards Models
Prostheses and Implants / statistics & numerical data*
Quality of Life
Risk Assessment
Sex Distribution
Sick Sinus Syndrome / mortality*,  therapy*
Survival Rate
Grant Support
ID/Acronym/Agency:
U01-HL-49804/HL/NHLBI NIH HHS; U01-HL-53973/HL/NHLBI NIH HHS; U01-HL-55981/HL/NHLBI NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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