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Updated: Jul 4, 2025
Translational Rabbit Model of Chronic Cardiac Pacing
Published on: January 6, 2023
Prognosis of pacing-dependent patients with cardiovascular implantable electronic devices
Wolfram Grimm1, Barbara Erdmann2, Kathrin Grimm3
1Department of Cardiology, University Hospital of Marburg and Gießen, Philipps-University Marburg, Baldingerstraße, 35033, Marburg, Germany. grimmwk.rauschenberg@t-online.de.
Insights
Pacing dependency in patients with cardiovascular implantable electronic devices (CIEDs) is not an independent predictor of all-cause mortality. Other factors like age, atrial fibrillation, kidney disease, and heart failure severity are more significant indicators.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Devices
Background:
- Prognostic significance of pacing dependency in patients with cardiovascular implantable electronic devices (CIEDs) is not well-established.
- Limited data exists on the impact of pacing dependency on mortality in CIED patients.
Purpose of the Study:
- To determine the prognostic significance of pacing dependency in patients with CIEDs.
- To identify predictors of all-cause mortality in patients with CIEDs.
Main Methods:
- Retrospective analysis of 786 patients with CIEDs.
- Pacing dependency defined as absence of intrinsic rhythm ≥ 30 bpm.
- Univariate and multivariate regression analyses were used to identify mortality predictors.
Main Results:
- Pacing dependency was observed in 130 patients, with 48% mortality versus 37% in 656 non-dependent patients (HR 1.34, P=0.04).
- Multivariate analysis identified age, atrial fibrillation, chronic kidney disease, and NYHA class ≥ III as independent predictors of mortality.
- Pacing dependency was not an independent predictor of all-cause mortality (HR 1.15, P=0.35).
Conclusions:
- Pacing dependency is not an independent predictor of all-cause mortality in patients with CIEDs.
- Age, atrial fibrillation, chronic kidney disease, and heart failure severity (NYHA class III/IV) are significant independent predictors of mortality.
Background:
Data on the prognostic significance of pacing dependency in patients with cardiovascular implantable electronic devices (CIEDs) are sparse.
Methods:
The prognostic significance of pacing dependency defined as absence of an intrinsic rhythm ≥ 30 bpm was determined in 786 patients with CIEDs at the authors' institution using univariate and multivariate regression analysis to identify predictors of all-cause mortality.
Results:
During 49 months median follow-up, death occurred in 63 of 130 patients with pacing dependency compared to 241 of 656 patients without pacing dependency (48% versus 37%, hazard ratio [HR] 1.34; 95% confidence interval [CI]: 1.02-1.78, P = 0.04). Using multivariate regression analysis, predictors of all-cause mortality included age (HR 1.07; 95% CI: 1.05-1.08, P < 0.01), history of atrial fibrillation (HR 1.32, 95% CI: 1.03-1.69, P < 0.01), chronic kidney disease (HR 1.28; 95% CI: 1.00-1.63, P = 0.048) and New York Heart Association (NYHA) class ≥ III (HR 2.00; 95% CI: 1.52-2.62, P < 0.01), but not pacing dependency (HR 1.15; 95% CI: 0.86-1.54, P = 0.35).
Conclusions:
In contrast to age, atrial fibrillation, chronic kidney disease and heart failure severity as indexed by NYHA functional class III or IV, pacing dependency does not appear to be an independent predictor of all-cause mortality in patients with CIEDs.
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