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Published on: September 24, 2021
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The estimated glomerular filtration rate predicts pacemaker-induced cardiomyopathy
Mitsunori Oida1, Eriko Hasumi2, Goto Kohsaku1
1Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo, 113-8655, Japan.
Scientific Reports
|October 2, 2023
Summary
Coronary artery disease history and low estimated glomerular filtration rate are key risk factors for pacemaker-induced cardiomyopathy (PICM) in patients with preserved ejection fraction. Early detection and monitoring are crucial for timely intervention.
Area of Science:
- Cardiology
- Medical Technology
Background:
- Pacemaker-induced cardiomyopathy (PICM) is a known complication, but risk factors in patients with preserved left ventricular ejection fraction (LVEF) are unclear.
- Previous studies identified QRS duration and left bundle branch block as predictors, but these may not apply to all patients.
Purpose of the Study:
- To identify independent risk factors for developing PICM in patients with preserved LVEF undergoing dual-chamber pacemaker implantation.
- To inform predictive strategies and clinical management for this patient population.
Main Methods:
- Retrospective analysis of 113 patients with preserved LVEF who underwent dual-chamber pacemaker implantation and had pre- and post-procedure echocardiography.
- Cox regression analysis was used to identify significant associations with PICM development.
Main Results:
- Thirty-three patients (29.2%) developed PICM.
- Univariate analysis revealed low estimated glomerular filtration rate (eGFR ≤ 30 mL/min/1.73 m²) and a history of coronary artery disease (CAD) as significant risk factors.
- Multivariate analysis confirmed low eGFR (HR 2.62) and CAD history (HR 2.32) as independent predictors of PICM.
Conclusions:
- A history of CAD and impaired kidney function (low eGFR) are significant independent risk factors for PICM in patients with preserved LVEF.
- These findings aid in predicting reduced LVEF post-pacemaker implantation and highlight the need for close echocardiographic monitoring and consideration of alternative pacing strategies.
