Long-term mortality outcomes according to the frequency of right ventricular pacing in veterans.
Background. Right ventricular pacing (RVP) has been associated with adverse outcomes, including heart failure and death. Minimizing RVP has been proposed as a therapeutic goal for a variety of pacing devices and indications. Objective. Quantify survival according to frequency of RVP in veterans with pacemakers. Methods. We analyzed electrograms from transtelephonic monitoring of veterans implanted with pacemakers between 1995 and 2005 followed by the Eastern Pacemaker Surveillance Center. We compared all cause mortality and time to death between patients with less than 20% and more than 80% RVP. Results. Analysis was limited to the 7198 patients with at least six trans-telephonic monitoring records (mean = 21). Average follow-up was 5.3 years. Average age at pacemaker implant was significantly lower among veterans with <20% RVP (67 years versus 72 years; P < .0001). An equal proportion of deaths during follow-up were noted for each group: 126/565 patients (22%) with <20% RVP and 1113/4968 patients (22%) with >80% RVP. However, average post-implant survival was 4.3 years with <20% RVP versus 4.7 years with >80% RVP (P < .0001). Conclusions. Greater frequency (>80%) of RVP was not associated with higher mortality in this population of veterans. Those veterans utilizing <20% RVP had a shortened adjusted survival rate (P = .0016).
Lampert
Brent C
BC
School of Medicine, Georgetown University, Washington, DC 20057, USA.
Moore
Hans J
HJ
Amdur
Richard L
RL
Karasik
Pamela E
PE
Lewis
Brian M
BM
Singh
Steven N
SN
Fletcher
Ross D
RD
J Am Coll Cardiol. 2003 Aug 20;42(4):624-6
12932591
Europace. 2008 Jul;10(7):825-31
18467299
Am Heart J. 1988 Jul;116(1 Pt 1):16-22
3394616
N Engl J Med. 2002 Jun 13;346(24):1854-62
12063369
N Engl J Med. 2001 Apr 5;344(14):1043-51
11287974
N Engl J Med. 2000 May 11;342(19):1385-91
10805823
J Am Coll Cardiol. 2004 Mar 17;43(6):1013-8
15028360
N Engl J Med. 2004 May 20;350(21):2140-50
15152059
Am J Cardiol. 2005 Apr 15;95(8):966-9
15820164
Circulation. 2003 Jun 17;107(23):2932-7
12782566
Heart Rhythm. 2005 Aug;2(8):830-4
16051118
Am J Cardiol. 1992 Nov 15;70(15):1320-5
1442585
Circulation. 1999 Jun 8;99(22):2927-33
10359738
N Engl J Med. 1998 Apr 16;338(16):1097-104
9545357
Lancet. 1997 Oct 25;350(9086):1210-6
9652562
Pacing Clin Electrophysiol. 2006 Jul;29(7):697-705
16884504
JAMA. 2002 Dec 25;288(24):3159-61
12495397