title: Prevalence and characterization of coronary artery disease in patients with symptomatic bradyarrhythmias requiring pacemaker implantation.
abstract: BACKGROUND
  This study was conducted to assess the prevalence and characterization of CAD in high risk patients requiring pacemaker implantation for symptomatic bradyarrhythmias.
  
  
  METHODS
  This study included 100 patients with symptomatic sinus node dysfunction or atrioventricular block, who were at high risk of CAD or had previously documented atherosclerotic vascular disease (ASCVD). Coronary angiography was performed before pacemaker implantation. CAD was defined as the presence of any degree of narrowing in at least one major coronary artery or its first order branch. Obstructive CAD was defined as ≥50% diameter stenosis. CAD was categorized as single vessel disease (SVD), double vessel disease (DVD), or triple vessel disease (TVD); and obstructive CAD in the arteries supplying the conduction system was sub-classified according to Mosseri's classification.
  
  
  RESULTS
  Out of 100 patients (mean age 64.6±10.7 years), 45 (45%) had CAD. 29% patients had obstructive CAD while 16% had non-obstructive CAD. 53.3% patients had SVD, 15.6% had DVD and 31.1% had TVD. Among patients with obstructive CAD; Type I, II, III and IV coronary anatomies were present in 6.9%, 34.5%, 10.3% and 48.3% patients respectively. Presence of CAD significantly correlated with dyslipidemia (p=0.047), history of smoking (p=0.025), and family history of CAD (p=0.002).
  
  
  CONCLUSIONS
  Angiographic CAD is observed in a substantial proportion of patients with symptomatic bradyarrhythmias and risk factors for CAD. It could be argued that such patients should undergo a coronary work-up before pacemaker implantation. Treatment of concomitant CAD is likely to improve the long term prognosis of these patients.
authors.affiliation: Department of Cardiology, SKIMS, Srinagar, India. Electronic address: mohdsultanalai@yahoo.in.
authors.forename: Mohammad S
authors.initials: MS
authors.lastname: Alai
authors.affiliation: Department of Cardiology, SKIMS, Srinagar, India. Electronic address: jahangir3582@gmail.com.
authors.forename: Jahangir Rashid
authors.initials: JR
authors.lastname: Beig
authors.affiliation: Department of Medicine, SKIMS, Srinagar, India. Electronic address: sanjayskims@gmail.com.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Kumar
authors.affiliation: Department of Cardiology, SKIMS, Srinagar, India. Electronic address: irfan0913@yahoo.co.in.
authors.forename: Irfan
authors.initials: I
authors.lastname: Yaqoob
authors.affiliation: Department of Cardiology, SKIMS, Srinagar, India. Electronic address: imihaf@gmail.com.
authors.forename: Imran
authors.initials: I
authors.lastname: Hafeez
authors.affiliation: Department of Cardiology, SKIMS, Srinagar, India. Electronic address: drajaz66@yahoo.com.
authors.forename: Ajaz A
authors.initials: AA
authors.lastname: Lone
authors.affiliation: Department of Cardiology, SKIMS, Srinagar, India. Electronic address: darmohdiqbal@yahoo.in.
authors.forename: Mohammad Iqbal
authors.initials: MI
authors.lastname: Dar
authors.affiliation: Department of Cardiology, SKIMS, Srinagar, India. Electronic address: eemaan3@yahoo.co.in.
authors.forename: Hilal A
authors.initials: HA
authors.lastname: Rather
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001919:Bradycardia / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed
keywords: Atrioventricular block; Bradyarrhythmias; Coronary artery disease; Permanent pacemaker; Sinus node dysfunction