Related Experiment Video
Updated: Jan 31, 2026
Real-Time Dynamic Navigation System for the Precise Quad-Zygomatic Implant Placement in a Patient with a Severely Atrophic Maxilla
Published on: October 18, 2021
Occurrence of significant long PR intervals in patients implanted for sinus node dysfunction and monitored with
Jérôme Taieb1, Pierre Le Franc2, Pierre Khattar3
1Service de cardiologie, centre hospitalier du Pays-d'Aix, avenue des Tamaris, 13616 Aix-en-Provence, France.
Insights
Nearly half of patients with sinus node dysfunction developed long PR intervals after pacemaker implantation. Amiodarone use predicted these intervals, which trended towards an association with new atrial fibrillation.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Device Technology
Background:
- Long PR intervals are associated with increased cardiovascular complications, including atrial fibrillation.
- Pacemaker SafeR™ mode monitors PR intervals, switching from AAI to DDD pacing if atrioventricular block criteria are met.
Purpose of the Study:
- To evaluate the incidence and predictors of long PR intervals (LPRIs) in patients with sinus node dysfunction (SND).
- To assess the association between LPRIs and incident atrial fibrillation (AF) after one year.
- To identify baseline predictors of LPRIs in patients without baseline conduction disorders.
Main Methods:
- Prospective, multicentre, observational trial (PRECISE study) in France.
- 214 patients with SND implanted with REPLY™ dual-chamber pacemakers, free from baseline conduction disorders.
- Pacemaker data analyzed for LPRIs (≥350/450ms consecutive PR/AR intervals) and AF (mode switch >1 min/day); logistic regression used for predictor analysis.
Main Results:
- After one year, 116 patients (54%) experienced LPRIs, and 63 patients (30%) developed AF.
- Amiodarone was the sole independent predictor of LPRIs (OR 2.50, 95% CI 1.20-5.21, P=0.014).
- A significant trend was observed between LPRIs and incident AF (OR 1.86, 95% CI 0.97-3.61, P=0.051).
Conclusions:
- Approximately half of patients with SND develop LPRIs within a year post-pacemaker implantation.
- Amiodarone is identified as the only independent predictor for developing LPRIs.
- A strong association trend exists between LPRIs and the incidence of atrial fibrillation.
Background:
Long PR intervals may increase cardiovascular complications, including atrial fibrillation. In pacemakers, the SafeR™ mode monitors PR intervals, switching from AAI to DDD when criteria for atrioventricular block are met.
Aims:
The PRECISE study evaluated the incidence and predictors of long PR intervals and their association with incident atrial fibrillation after 1 year in patients implanted for sinus node dysfunction and free from significant conduction disorders at baseline.
Methods:
This French, prospective, multicentre, observational trial enrolled patients implanted with a REPLY™ dual-chamber pacemaker. Pacemaker memory recorded long PR intervals (defined as first-degree atrioventricular block mode switches occurring after six consecutive PR/AR intervals≥350/450ms) and atrial fibrillation incidence (fallback mode switch>1minute/day). Predictors were identified from baseline variables (age, sex, AR and PR intervals, atrial rhythm disorder and medication) using logistic regression.
Results:
Of 291 patients with sinus node dysfunction enrolled, 214 were free from significant conduction disorders at baseline (mean age 79±8 years; 44% men; PR/AR intervals<350/450ms). After 1 year, long PR intervals had occurred in 116 patients (54%) and atrial fibrillation in 63 patients (30%). Amiodarone was the only independent predictor of long PR interval occurrence (odds ratio 2.50, 95% confidence interval 1.20-5.21; P=0.014). There was a strong trend towards an association between long PR interval and atrial fibrillation incidence (odds ratio 1.86, 95% confidence interval 0.97-3.61; P=0.051).
Conclusions:
Half of the patients with pure sinus node dysfunction developed long PR intervals in the year following pacemaker implantation. Amiodarone was the only independent predictor of long PR intervals. There was a strong trend towards an association between long PR intervals and incident atrial fibrillation.
Related Concept Videos
01:03Prediction Intervals
However, the point estimate is most likely not the exact value of the population parameter, but close to it. After calculating point estimates, we construct interval estimates, called confidence intervals or prediction intervals. This prediction interval comprises a range of values unlike the point estimate and is a better predictor of the observed sample value, y.
01:21Types of Reports II: Incident or Occurrence Report
Purposes:
In the healthcare industry, reports play a crucial role in documenting incidents within an agency. The primary objective of these reports is to ensure patient safety, uphold the...
01:21Confidence Intervals
A...
01:29Improper Integrals: Infinite Intervals
03:37Uncertainty in Measurement: Accuracy and Precision
01:16ECG Interpretation of Arrhythmias I: Sinus Arrhythmias
Types of Arrhythmias
Sinus Node Arrhythmias
Sinus Bradycardia: Originating from the sinoatrial (SA) node, sinus bradycardia involves slower impulses, resulting in a heart rate of less than 60 beats per minute (bpm). Causes include sleep, vagal stimulation, beta-blockers, hypothyroidism,...