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Clinical Outcomes Following PM Implantation: A 3-Year Comparative Study of Sick Sinus Syndrome and Atrioventricular

Fuat Polat1,2, Haşim Tüner3, Veysi Can4

  • 1Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Education Research Hospital, Istanbul - Turquia.

Arquivos Brasileiros De Cardiologia
|July 22, 2026
PubMed

Insights

Permanent pacemaker implantation offers similar symptom relief for sick sinus syndrome (SSS) and atrioventricular block (AVB). However, distinct cardiac remodeling patterns and mortality predictors necessitate etiology-specific follow-up strategies for pacemaker recipients.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Cardiac Imaging

Background:

  • Permanent pacemaker implantation is a standard treatment for sick sinus syndrome (SSS) and atrioventricular block (AVB).
  • Limited comparative data exist on long-term outcomes and cardiac remodeling between SSS and AVB after pacemaker implantation.

Purpose of the Study:

  • To compare three-year clinical outcomes and cardiac structural changes in patients with SSS versus AVB post-pacemaker implantation.
  • To identify distinct cardiac remodeling patterns and mortality predictors based on bradyarrhythmic etiology.

Main Methods:

  • Retrospective observational study of 192 adult patients (65 SSS, 127 AVB) undergoing pacemaker implantation.
  • Assessment of demographic, echocardiographic, pacemaker, and clinical data at baseline and up to three years.
  • Primary outcomes included cardiac structure/function changes, symptomatic improvement, atrial fibrillation, rehospitalization, and mortality.

Main Results:

  • Both SSS and AVB groups showed similar declines in left ventricular ejection fraction over three years.
  • SSS patients exhibited significant left atrial and ventricular dilation with increased mitral regurgitation.
  • AVB patients maintained stable chamber dimensions despite high ventricular pacing; mortality predictors differed between groups.

Conclusions:

  • Sick sinus syndrome and atrioventricular block patients experience comparable symptomatic benefits and clinical outcomes after pacemaker implantation.
  • Distinct cardiac remodeling patterns and differing mortality predictors underscore the need for etiology-specific follow-up strategies.
  • Etiology-specific management may optimize long-term care for individuals with bradyarrhythmias requiring pacemakers.
Abstract

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