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Cha Y, Metzl M, Canby R, Fruechte E, Duggal M, Exner D, Chung E, Singh J, O'Donnell D, Zimmerman P, Landman S, Lexcen D, Laager V, Schaber D, Cheng A. RV Pacing Percentage. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Chronic right ventricular pacing (RVP) has been associated with dyssynchrony, leading to increased mortality. However, there have been discrepancies in previous reports in the effect of RVP levels.
Objective
To sub-stratify mortality risk by age for different RVP level groups within a large real-world ICD cohort.
Methods
Optum® de-identified electronic health records were linked to the Medtronic Carelink data to identify dual chamber ICD recipients (2007–2017). RVP level was based on median daily pacing during the first 90 days post-implant and categorized either into groups with a cutoff of 40%, or with groups of 0–9%, 10–19%, 20–29%, 30–39%, 40–49%, and 50–100%. The endpoint was death more than 90 days post-implant. Kaplan-Meier survival curves, log-rank tests, and Cox regression were used to analyze the relationship between RVP and risk of death.
Results
Among 14,832 ICD patients (median age 67; 74.0% male), there were 2,602 deaths within 10 years after implant. In unadjusted comparisons, high RVP (>40%) increased the risk of death relative to low RVP (≤40%) (p<0.001). This effect remained significant in older cohort (≥67 years old at implant) (p<0.001), but not in younger cohort (<67 years old) (p=0.955) (Figure). After controlling for age, gender, pacing mode, MI, SCA, HF hospitalization, diabetes, and renal dysfunction, similar or increased risk was associated with higher pacing groups relative to the 0–9% pacing group in the older cohort, but not in the younger cohort.
Conclusions
Our data from a large contemporaneous real-world source suggests that older age or characteristics associated with age make patients more sensitive to chronic RVP effects. These results help reconcile differences observed in prior studies.
Funding Acknowledgement
Type of funding source: Private company. Main funding source(s): Medtronic, Inc.
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Affiliation(s)
- Y.M Cha
- Mayo Clinic, Rochester, United States of America
| | - M.D Metzl
- Evanston Hospital Northshore, Evanston, United States of America
| | - R.C Canby
- Texas Cardiac Arrhythmia Research, Austin, United States of America
| | - E.M Fruechte
- North Memorial Heart and Vascular Institute, Robbinsdale, United States of America
| | - M Duggal
- Advocate Christ Medical Center, Oak Lawn, United States of America
| | - D.V Exner
- University of Calgary, Libin Cardiovascular Institute, Calgary, Canada
| | - E.S Chung
- The Christ Hospital, Cincinnati, United States of America
| | - J.P Singh
- Harvard Medical School, Boston, United States of America
| | | | - P Zimmerman
- Medtronic, Inc., Mounds View, United States of America
| | - S Landman
- Medtronic, Inc., Mounds View, United States of America
| | - D.R Lexcen
- Medtronic, Inc., Mounds View, United States of America
| | - V Laager
- Medtronic, Inc., Mounds View, United States of America
| | - D Schaber
- Medtronic, Inc., Mounds View, United States of America
| | - A Cheng
- Medtronic, Inc., Mounds View, United States of America
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Love C, Gleva M, Surber R, Zhong Y, Liu F, Lexcen D. P1036Real world evaluation of ventricular fibrillation detection after magnetic resonance imaging in patients with an MR conditional ICD or CRT-D. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p1036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- C Love
- Johns Hopkins University of Baltimore, Medicine/Cardiology, Baltimore, United States of America
| | - M Gleva
- Washington University School of Medicine, Medicine, St. Louis, United States of America
| | - R Surber
- Friedrich Schiller University, Jena, Germany
| | - Y Zhong
- Medtronic, Inc, Minneapolis, United States of America
| | - F Liu
- Medtronic, Inc, Minneapolis, United States of America
| | - D Lexcen
- Medtronic, Inc, Minneapolis, United States of America
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Boersma L, Merkely B, Neuzil P, Crozier I, Akula D, Timmers L, Kalarus Z, Sherfesee L, Thompson A, Lexcen D, Knight B. 3406The acute extravascular defibrillation, pacing and electrogram (ASD2) study results. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.3406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- L Boersma
- St Antonius Hospital, Department of Cardiology, Nieuwegein, Netherlands
| | - B Merkely
- Semmelweis University Heart Center, Budapest, Hungary
| | - P Neuzil
- Na Homolce Hospital, Prague, Czech Republic
| | - I Crozier
- Christchurch Hospital, Christchurch, New Zealand
| | - D Akula
- Lourdes Cardiology Center, Voorhees, United States of America
| | - L Timmers
- Ghent University Hospital (UZ), Ghent, Belgium
| | - Z Kalarus
- Slaski Heart Disease Center, Zabrze, Poland
| | - L Sherfesee
- Medtronic, Minneapolis, United States of America
| | - A Thompson
- Medtronic, Minneapolis, United States of America
| | - D Lexcen
- Medtronic, Minneapolis, United States of America
| | - B Knight
- Northwestern Memorial Hospital, Chicago, United States of America
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