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Trends of temporary pacemaker implant and underlying disease substrate.
MedLine Citation:
PMID:  20946290     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
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.
Authors:
Yu-Lan Jou; Hong-Pin Hsu; Ta-Chuan Tuan; Kang-Ling Wang; Yenn-Jiang Lin; Li-Wei Lo; Yu-Feng Hu; Chi-Woon Kong; Shih-Lin Chang; Shih-Ann Chen
Publication Detail:
Type:  Journal Article     Date:  2010-10-14
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  33     ISSN:  1540-8159     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-12-07     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1475-84     Citation Subset:  IM    
Copyright Information:
©2010, The Authors. Journal compilation ©2010 Wiley Periodicals, Inc.
Affiliation:
Division of Cardiology, Taipei City Hospital, Yang-Ming Branch, Taipei, Taiwan.
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