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Risk factors and incidence of new-onset heart failure with conventional pacemakerimplant – a nationwide study

Farouq, Maiwand LU ; Rorsman Schough, Cecilia LU ; Marinko, Sofia LU ; Mortsell, David LU orcid ; Chaudhry, Uzma LU ; Wang, Lingwei LU orcid ; Platonov, Pyotr LU and Borgquist, Rasmus LU orcid (2024) In Heart Rhythm O2
Abstract
Background
Studies have shown that the risk of new-onset heart failure (HF) is higher post-implant for patients receiving right ventricular pacing.

Objective
This study aimed to investigate incidence, risk factors and implications for long-term prognosis of new-onset HF in patients after pacemaker-implant.

Methods
Patients without preexisting HF who received a pacemaker in Sweden during the period 2005-2020 were identified via the nationwide Pacemaker Registry. Data was crossmatched with the population registry and national disease registries. Primary outcome was new-onset HF within 5 years, and a risk score for this was developed and validated..

Results
In all, 65579 patients met the inclusion... (More)
Background
Studies have shown that the risk of new-onset heart failure (HF) is higher post-implant for patients receiving right ventricular pacing.

Objective
This study aimed to investigate incidence, risk factors and implications for long-term prognosis of new-onset HF in patients after pacemaker-implant.

Methods
Patients without preexisting HF who received a pacemaker in Sweden during the period 2005-2020 were identified via the nationwide Pacemaker Registry. Data was crossmatched with the population registry and national disease registries. Primary outcome was new-onset HF within 5 years, and a risk score for this was developed and validated..

Results
In all, 65579 patients met the inclusion criteria (10351 single chamber ventricular and 55228 dual chamber pacemakers). 13792 (21.0%) patients were diagnosed with HF within five years post-implant. Of these, 6244 (45.3%) were hospitalized for HF. Patients with new-onset heart failure were more likely to die within five years (41.2% vs. 19.7%, p<0.0001). Risk factors for new-onset HF included increasing age, male sex, hypertension, diabetes, atrial fibrillation, chronic lung- and kidney disease, ischemic heart disease, and AV block. In a combined score using these variables, patients in the highest risk-score quartile had a hazard ratio of 5.36 [4.91-5.86] (p<0.001) and an absolute risk of 32% for developing HF.

Conclusion
Pacemaker therapy is associated with >20% risk of new-onset HF within five years, and we identified nine risk factors associated with the diagnosis of new-onset HF. The proposed score based on these variables can be used to identify patients at high risk for new-onset heart failure (Less)
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author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
in press
subject
in
Heart Rhythm O2
publisher
Elsevier
ISSN
2666-5018
DOI
10.1016/j.hroo.2024.07.012
language
English
LU publication?
yes
id
25d5e770-0eff-45a8-8584-cabf798597bb
date added to LUP
2024-07-24 12:31:59
date last changed
2024-07-25 12:32:16
@article{25d5e770-0eff-45a8-8584-cabf798597bb,
  abstract     = {{Background<br/>Studies have shown that the risk of new-onset heart failure (HF) is higher post-implant for patients receiving right ventricular pacing.<br/><br/>Objective<br/>This study aimed to investigate incidence, risk factors and implications for long-term prognosis of new-onset HF in patients after pacemaker-implant.<br/><br/>Methods<br/>Patients without preexisting HF who received a pacemaker in Sweden during the period 2005-2020 were identified via the nationwide Pacemaker Registry. Data was crossmatched with the population registry and national disease registries. Primary outcome was new-onset HF within 5 years, and a risk score for this was developed and validated..<br/><br/>Results<br/>In all, 65579 patients met the inclusion criteria (10351 single chamber ventricular and 55228 dual chamber pacemakers). 13792 (21.0%) patients were diagnosed with HF within five years post-implant. Of these, 6244 (45.3%) were hospitalized for HF. Patients with new-onset heart failure were more likely to die within five years (41.2% vs. 19.7%, p&lt;0.0001). Risk factors for new-onset HF included increasing age, male sex, hypertension, diabetes, atrial fibrillation, chronic lung- and kidney disease, ischemic heart disease, and AV block. In a combined score using these variables, patients in the highest risk-score quartile had a hazard ratio of 5.36 [4.91-5.86] (p&lt;0.001) and an absolute risk of 32% for developing HF.<br/><br/>Conclusion<br/>Pacemaker therapy is associated with &gt;20% risk of new-onset HF within five years, and we identified nine risk factors associated with the diagnosis of new-onset HF. The proposed score based on these variables can be used to identify patients at high risk for new-onset heart failure}},
  author       = {{Farouq, Maiwand and Rorsman Schough, Cecilia and Marinko, Sofia and Mortsell, David and Chaudhry, Uzma and Wang, Lingwei and Platonov, Pyotr and Borgquist, Rasmus}},
  issn         = {{2666-5018}},
  language     = {{eng}},
  month        = {{07}},
  publisher    = {{Elsevier}},
  series       = {{Heart Rhythm O2}},
  title        = {{Risk factors and incidence of new-onset heart failure with conventional pacemakerimplant – a nationwide study}},
  url          = {{http://dx.doi.org/10.1016/j.hroo.2024.07.012}},
  doi          = {{10.1016/j.hroo.2024.07.012}},
  year         = {{2024}},
}