Development of Atrioventricular Block and Diagnostic Value of Stored Electrograms in Patients With Sick Sinus Syndrome and Implanted Pacemaker

Circulation Journal : Official Journal of the Japanese Circulation Society
Junya HosodaSatoshi Umemura

Abstract

The incidence of atrioventricular block (AVB) in pacemaker patients with sick sinus syndrome (SSS) is not yet known. The aim of this study was to analyze AVB episodes in SafeR mode based on stored electrograms (EGM), and determine the occurrence rate and risk factors for advanced AVB in a pacemaker population with SSS. The study included 50 consecutive patients with SSS without a history of advanced AVB who had a dual-chamber pacemaker programmed in SafeR mode. A total of 377 EGM stored in the pacemakers as AVB episodes fulfilling the second- or third-degree criterion were analyzed. Of 377 EGM, 73 EGM (19.4%) were appropriate episodes, whereas the other EGM did not show actual AVB, and showed atrial tachyarrhythmia, ventricular event in the blanking period, or premature atrial contractions with block. On EGM analysis, advanced AVB occurred in 9 patients (18%), and the occurrence rate was 11.7% per year. Moreover, on multivariate analysis β-blocker use was an independent risk factor for advanced AVB (OR, 9.10; P=0.004). The occurrence rate of advanced AVB in patients with SSS is much higher than previously reported, and β-blocker use is an independent risk factor for advanced AVB. SafeR is useful to detect latent AVB. Stored EGM...Continue Reading

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Citations

May 8, 2015·Circulation Journal : Official Journal of the Japanese Circulation Society·Mikiko Nakagawa
Jul 28, 2016·Circulation Journal : Official Journal of the Japanese Circulation Society·Tai FuchigamiKazuhiro Takahashi
May 19, 2018·Journal of the American Veterinary Medical Association·Romain PariautRoberto A Santilli

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