title: Predictors of improved quality of life 1 year after pacemaker implantation.
abstract: BACKGROUND
  Patient's health-related quality of life (HRQoL) of pacemaker (PM) patients has increasingly become an important issue of health care evaluation. Currently, knowledge of pacing performance and technology is more or less outlined. However, determinants of poor or good HRQoL of paced patients require further elucidation.
  
  
  OBJECTIVE
  The purpose of this study is to determine the HRQoL 1 year after PM implantation and predictors of differences in HRQoL between pre- and post-PM implantation.
  
  
  METHODS
  We quantified the mean differences between HRQoL before implantation (baseline) and 1 year later, assessed with the generic Medical Outcomes Survey 36-Item Short-Form Survey and EuroQol (EQ5D), and the PM patient-specific AQUAREL (Assessment of QUality of life And RElated events) questionnaires, in 501 consecutively included patients in the Dutch multicenter longitudinal FOLLOWPACE cohort study. Multivariable linear regression modeling was then performed to determine predictive factors of the HRQoL 1 year after implantation.
  
  
  RESULTS
  The HRQoL of the patients increased markedly in the first year after implantation. Seventy percent of the patients considered their health improved, whereas 11% experienced a complete recovery in HRQoL. The most important predictors for improved HRQoL after 1 year were HRQoL at baseline, age, presence of cardiac comorbidities, and atrial fibrillation with slow ventricular response as indication for chronic pacing.
  
  
  CONCLUSIONS
  In most patients receiving a PM, HRQoL increased in the first year after PM implantation. Knowledge of the predictors of this increase may aid physicians to timely differentiate between patients who most likely will benefit most from PM implantation in terms of HRQoL.
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands. j.w.m.vaneck-2@umcutrecht.nl
authors.forename: J W Martijn
authors.initials: JW
authors.lastname: van Eck
authors.forename: Norbert M
authors.initials: NM
authors.lastname: van Hemel
authors.forename: Arjan
authors.initials: A
authors.lastname: van den Bos
authors.forename: William
authors.initials: W
authors.lastname: Taks
authors.forename: Diederick E
authors.initials: DE
authors.lastname: Grobbee
authors.forename: Karel G M
authors.initials: KG
authors.lastname: Moons