Increased ventricular pacing threshold levels in patients with high serum uric acid levels

Permanent cardiac pacemakers (PCM) are accepted as the most effective treatment for symptomatic bradyarrhythmias. Serum uric acid (UA) levels are associated with various inflammatory markers, oxidative stress, and endothelial dysfunction. This study aimed to investigate the association between serum UA and ventricular pacing threshold (VPT) levels in patients who underwent permanent pacemaker implantation.

We retrospectively analyzed a total of 198 patients who underwent PCM implantation for indications such as symptomatic bradycardia without a reversible etiology and high-degree and complete atrioventricular block.

VPT values were found to correlate with serum UA levels (r=0.591, p<0.001), high sensitivity C-reactive protein (hs-CRP) levels (r=0.505, p<0.001), and ventricular impedance (r=0.220, p=0.016). The serum UA levels and hs-CRP levels were also correlated (r=0.691, p<0.001). To identify independent risk factors for VPT values, a multivariate linear regression model was conducted, and serum UA levels (β=0.361, p=0.001), hs-CRP levels (β=0.277, p=0.012), and impedance values (β=0.207, p=0.011) were found to be independent risk factors for VPT.

In the present study, VPT values at the time of implantation and at the 30th day were increased in patients with high serum UA levels. To further extend the life of pacemakers, as well as other factors that affect threshold values, serum UA levels should be noted.