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Demographic Patterns and Sex-Based Differences in Permanent Pacemaker Implantation: a Six-Year Observational Study
Pranab Jyoti Bhattacharyya1, Pawan Kumar1, Farhin Iqbal1
1Department of Cardiology, Gauhati Medical College, Guwahati, Assam, India.
Objectives:
Permanent pacemaker (PPM) implantation data and sex-based differences have not been well described in North Eastern India. This study aimed to evaluate the demographic profile, clinical characteristics and sex-based differences among patients undergoing PPM implantation at our center.
Methods:
We prospectively collected data on all patients undergoing PPM implantation between January 2014 and December 2019. The collected data were retrospectively analyzed for demographic characteristics, clinical indications and sex-based differences.
Results:
A total of 1771 patients were included with a male to female ratio of 2.7:1. Mean age of the study population was 62.66 ± 12.46 years. The commonest conduction abnormality was complete heart block observed in 935 (52.80%) followed by sick sinus syndrome in 208 (11.74%) patients. Sick sinus syndrome (19.21% vs 8.98%; p < 0.001) and junctional bradycardia (1.25% vs 0.31%; p = 0.046) were more common in females. On multivariable logistic regression, female sex was an independent predictor of sick sinus syndrome (OR 2.35, 95% CI 1.74-3.17; p <0.001). Atrial capture threshold was higher (0.62 ± 0.21 vs 0.58 ± 0.21; p < 0.05) and sensed P-wave amplitudes were significantly lower in females compared to males (2.52 ± 0.64 vs 2.74 ± 0.71; p <0.001).
Conclusions:
This study represents one of the first comprehensive regional studies on demographic patterns and sex-based differences of patients undergoing PPM implantation in North Eastern India. Complete heart block was the leading indication, followed by sick sinus syndrome. Females more often received implants for sick sinus syndrome and showed higher atrial pacing thresholds with lower P-wave amplitudes.
