title: Prognosis of patients with implanted pacemakers in 4‑year follow-up : Impact of right ventricular pacing site.
abstract: BACKGROUND
  Pacing remains the method of choice for treatment of cardiac electrical conduction disorders. This study examined the interrelationship between the site of the right ventricular lead tip and patient prognosis in association with other cardiovascular risk factors over a 4‑year follow-up period.
  
  
  METHODS
  The study comprised 450 consecutive patients (223 women; aged 69.16 ± 9.63 years) who had their first SSI or DDD pacemaker implanted for typical indications.
  
  
  RESULTS
  During follow-up, 91 (20.2%) patients died. The positive prognostic factors were: female sex (hazard ratio [HR] = 0.426), DDD pacemaker (HR = 0.526), oral anticoagulant use (HR = 0.330; all groups), sodium concentration (HR = 0.926), oral anticoagulant (HR = 0.115) and statin (HR = 0.260) use (female group), and non-apical location of the right ventricular lead tip (HR = 0.549; male group). Risk factors for death were: age (HR = 1.063), diabetes requiring insulin (HR = 2.832), creatinine concentration (HR = 1.005; all groups), age (HR = 1.11; female group), and elevated creatinine level (HR = 1.012; male group). In all patients, the non-apical location of the right ventricular lead tip was associated with an 18.92% reduced mortality rate during the 4‑year follow-up, which was statistically significant for the male group.
  
  
  CONCLUSIONS
  The non-apical location of the right ventricular lead tip was a positive prognostic factor and was statistically significant in the male subgroup.
authors.affiliation: Szpital Specjalistyczny w Zabrzu, Zabrzu, Poland.
authors.forename: K
authors.identifier: http://orcid.org/0000-0002-1919-244X
authors.initials: K
authors.lastname: Krzemień-Wolska
authors.affiliation: Szpital Specjalistyczny w Zabrzu, Zabrzu, Poland.|Second Department of Cardiology, Medical University of Silesia, ul. Skłodowskiej 10, 41-800, Zabrzu, Poland.
authors.forename: A
authors.initials: A
authors.lastname: Tomasik
authors.affiliation: Szpital Specjalistyczny w Zabrzu, Zabrzu, Poland.|Second Department of Cardiology, Medical University of Silesia, ul. Skłodowskiej 10, 41-800, Zabrzu, Poland.
authors.forename: E
authors.initials: E
authors.lastname: Nowalany-Kozielska
authors.affiliation: Szpital Specjalistyczny w Zabrzu, Zabrzu, Poland. wjachec@interia.pl.|Second Department of Cardiology, Medical University of Silesia, ul. Skłodowskiej 10, 41-800, Zabrzu, Poland. wjachec@interia.pl.
authors.forename: W
authors.initials: W
authors.lastname: Jacheć
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002304:Cardiac Pacing, Artificial; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Arrhythmias; Cardiac pacing, artificial; Heart conduction system; Mortality; Right ventricle