title: [Risk factors for heart failure after right ventricular apical pacing].
abstract: OBJECTIVE
  To explore the prevalence and risk factors for the onset of heart failure after right ventricular apical pacing.
  
  
  METHODS
  The clinical data of 1 343 patients with pacemaker implantation at our hospital from 2003 to 2008 were analyzed retrospectively. And the predictors of heart failure were evaluated by the Cox proportional hazard model and Kaplan-Meier method.
  
  
  RESULTS
  During a median follow-up period of 71 (76±24) months, 303 patients (22.6%) developed a new onset of heart failure. Multivariate Cox analysis revealed that ≥65 years old (hazard ratio 2.37), a history of myocardial infarction (hazard ratio 2.16), VVI mode (hazard ratio 2.37), left ventricular ejection fraction (LVEF)<50% (hazard ratio 2.00), atrioventricular block or atrial fibrillation with slow ventricular rate etiologically (hazard ratio 1.43) were independent risk factors for heart failure (P<0.05). And the risks increased by 19.4%, 33.0%, 20.9%, 38.4%, 17.2% or 25.9% at 71 months respectively.
  
  
  CONCLUSIONS
  After right ventricular apical pacing, heart failure is a progressive syndrome correlated with basal cardiac functions, underlying etiologies and age. And right ventricular apical pacing should be avoided in patients with high risk factors.
authors.affiliation: Department of Cardiology, Tianjin Chest Hospital, Tianjin 300222, China.
authors.forename: Dongyan
authors.initials: D
authors.lastname: Wu
authors.affiliation: Department of Cardiology, Tianjin Chest Hospital, Tianjin 300222, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Cardiology, Tianjin Chest Hospital, Tianjin 300222, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Cardiology, Tianjin Chest Hospital, Tianjin 300222, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Ma
authors.affiliation: Department of Cardiology, Tianjin Chest Hospital, Tianjin 300222, China.
authors.forename: Dujing
authors.initials: D
authors.lastname: Shao
authors.affiliation: Department of Cardiology, Tianjin Chest Hospital, Tianjin 300222, China.
authors.forename: Fengmin
authors.initials: F
authors.lastname: Lu
authors.affiliation: Department of Cardiology, Tianjin Chest Hospital, Tianjin 300222, China; Email: drxj@hotmail.com.
authors.forename: Jing
authors.initials: J
authors.lastname: Xu
mesh_terms: D001281:Atrial Fibrillation; D054537:Atrioventricular Block; D002304:Cardiac Pacing, Artificial; D006333:Heart Failure; D006352:Heart Ventricles; D006801:Humans; D015994:Incidence; D010138:Pacemaker, Artificial; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D016277:Ventricular Function, Left