Related Experiment Videos
Survival rates after pacemaker implantation: a study of patients paced for sick sinus syndrome and atrioventricular
R Zanini1, A Facchinetti, G Gallo
1Department of Cardiology, Spedali Civili, Brescia, Italy.
Insights
Patients with Sick Sinus Syndrome (SSS) requiring pacemakers show a trend towards higher survival rates compared to those with atrioventricular block (AVB). Age and pacing mode significantly influence survival in pacemaker patients.
Area of Science:
- Cardiology
- Medical Statistics
Background:
- Pacemaker implantation is a common procedure for managing cardiac rhythm disorders.
- The long-term prognosis and survival rates for patients paced for atrioventricular block (AVB) versus Sick Sinus Syndrome (SSS) remain controversial.
Purpose of the Study:
- To compare the survival rates of patients with AVB versus SSS who underwent pacemaker implantation.
- To identify factors influencing mortality and survival patterns in these patient groups.
Main Methods:
- Retrospective analysis of 962 AVB patients and 283 SSS patients implanted between 1968 and 1986.
- Survival rates calculated using the actuarial method; differences assessed with the Logrank test.
- Multivariate discriminant analysis used to evaluate influencing factors on mortality.
Main Results:
- Sick Sinus Syndrome patients demonstrated a higher survival rate than AVB patients, approaching statistical significance.
- Age at implantation and pacing mode were the primary determinants of survival.
- Underlying heart disease had a minor influence, while the electrophysiological indication for pacing did not significantly affect survival.
Conclusions:
- Pacemaker recipients with SSS generally have a better survival outlook than those with AVB.
- Patient age and the type of pacing mode are critical prognostic indicators, underscoring the importance of personalized pacing strategies.
Abstract:
It is still a matter of controversy as to whether the patients paced for atrioventricular block (AVB) have different prognosis and survival rates than those paced for Sick Sinus Syndrome (SSS). We have compared the survival rates of 962 AVB patients (group A) with that of 283 SSS patients (group B) who underwent pacemaker implantation during the period January 1968 to December 1986. The survival rate graphs of the examined groups were calculated using the actuarial method and the differences in the survival rates between the groups were evaluated using the Logrank test. Our results show that SSS patients have a higher survival rate than AV block with a difference on the rate of survival between the two groups reaching the borderline of statistical significance. Multivariate discriminant analysis was then used to assess that of the parameters (i.e., age at the time of implantation, sex, electrophysiological indication to pacing, etiology or pacing mode) could have had the main influence upon mortality and the different pattern of the survival rate graph within the two groups of patients. Our data show that survival is mostly related to age, pacing mode and, although more slightly, to underlying heart disease; the electrophysiological indication to pacing, instead, does not significantly influence it.