title: Percutaneous coronary intervention delays pacemaker implantation in coronary artery disease patients with established bradyarrhythmias.
abstract: BACKGROUND
  Pacemakers have long been used to assist the heart under pathological conditions, and they are the first choice in the treatment of systematic bradyarrhythmias. However, the effect of percutaneous coronary intervention (PCI) in patients with coronary artery disease as well as bradyarrhythmias remains unknown.
  
  
  METHODS
  In the present study, 42 patients with chest pain and/or abnormal stress test results were surveyed. Before coronary angiography, patients underwent complete examination, including a 24 h dynamic electrocardiogram, which was used to diagnose bradyarrhythmias that were not suitable for pacemaker implantation due to a lack of arrhythmia-related symptoms. All patients underwent PCI but did not undergo pacemaker implantation. Forty-one patients with chest pain and/or abnormal stress test results, as well as symptom-free bradyarrhythmias, were selected as the control group. All of the patients in the control group were committed to treatments without PCI.
  
  
  RESULTS
  During a mean (±SD) of 3.3±0.5 years of follow-up (range 2.5 to 4.5 years), 24 of 42 patients who received PCI underwent pacemaker implantation for arrhythmia-related symptoms, eight were shown by Holter monitoring to have worsened but still exhibited no symptoms, and the remainder did not show any changes according to the examinations performed. In the control group, 31 patients underwent pacemaker implantation for arrhythmia-related symptoms, eight were shown by Holter monitoring to have worsened but still exhibited no symptoms, and two did not show any changes according to the examinations performed. Nevertheless, the rates of pacemaker implantation each year (from the first to the third year) between the two groups were 7.1% versus 39.0% (P=0.001); 33.3% versus 63.4% (P=0.006); and 57.1% versus 75.6%, (P=0.075), respectively.
  
  
  CONCLUSIONS
  The present study found that PCI delayed the demand for pacemaker implantation among coronary artery disease patients.
authors.affiliation: Department of Cardiology, The Fourth Clinical Hospital of Harbin Medical University, Harbin, China.
authors.forename: Lihua
authors.initials: L
authors.lastname: Zhong
authors.forename: Yanhui
authors.initials: Y
authors.lastname: Gao
authors.forename: Hongyuan
authors.initials: H
authors.lastname: Xia
authors.forename: Xueqi
authors.initials: X
authors.lastname: Li
authors.forename: Shipeng
authors.initials: S
authors.lastname: Wei
keywords: Pacemaker; Percutaneous coronary intervention; Sinus node diseases