Pacemaker implantation following tricuspid valve annuloplasty: A SWEDEHEART study
Ragnarsson, Sigurdur LU ; Taha, Amar ; J Nielsen, Susanne ; Amabile, Andrea ; Geirsson, Arnar ; Krane, Markus ; Mortsell, David LU
; Sjögren, Johan
LU
; Anders, Jepsson
and Andreas, Martinsson
(2023)
In Journal of Thoracic and Cardiovascular Surgery
16.
p.276-289
- Abstract
- Objective
Tricuspid annuloplasty is associated with increased risk of atrioventricular block and subsequent implantation of a permanent pacemaker. However, the exact incidence of permanent pacemaker, associated risk factors, and outcomes in this frame remain debated. The aim of the study was to report permanent pacemaker incidence, risk factors, and outcomes after tricuspid annuloplasty from nationwide databases.
Methods
By using data from multiple Swedish mandatory national registries, all patients (n = 1502) who underwent tricuspid annuloplasty in Sweden from 2006 to 2020 were identified. Patients who needed permanent pacemaker within 30 days from surgery were compared with those who did not. The cumulative incidence of... (More) - Objective
Tricuspid annuloplasty is associated with increased risk of atrioventricular block and subsequent implantation of a permanent pacemaker. However, the exact incidence of permanent pacemaker, associated risk factors, and outcomes in this frame remain debated. The aim of the study was to report permanent pacemaker incidence, risk factors, and outcomes after tricuspid annuloplasty from nationwide databases.
Methods
By using data from multiple Swedish mandatory national registries, all patients (n = 1502) who underwent tricuspid annuloplasty in Sweden from 2006 to 2020 were identified. Patients who needed permanent pacemaker within 30 days from surgery were compared with those who did not. The cumulative incidence of permanent pacemaker implantation was estimated. A multivariable logistic regression model was fit to identify risk factors of 30-day permanent pacemaker implantation. The association between permanent pacemaker implantation and long-term survival was evaluated with multivariable Cox regression.
Results
The 30-day permanent pacemaker rate was 14.2% (214/1502). Patients with permanent pacemakers were older (69.8 ± 10.3 years vs 67.5 ± 12.4 years, P = .012). Independent risk factors of permanent pacemaker implantation were concomitant mitral valve surgery (odds ratio, 2.07; 95% CI, 1.34-3.27), ablation surgery (odds ratio, 1.59; 95% CI, 1.12-2.23), and surgery performed in a low-volume center (odds ratio, 1.85; 95% CI, 1.17-2.83). Permanent pacemaker implantation was not associated with increased long-term mortality risk (adjusted hazard ratio, 0.74; 95% CI, 0.53-1.03).
Conclusions
This nationwide study demonstrated a high risk of permanent pacemaker implantation within 30 days of tricuspid annuloplasty. However, patients who needed a permanent pacemaker did not have worse long-term survival, and the cumulative incidence of heart failure and major adverse cardiovascular events was similar to patients who did not receive a permanent pacemaker. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/73e56d19-e21f-4929-9fcc-cb796a282aa5
- author
- Ragnarsson, Sigurdur
LU
; Taha, Amar
; J Nielsen, Susanne
; Amabile, Andrea
; Geirsson, Arnar
; Krane, Markus
; Mortsell, David
LU
; Sjögren, Johan
LU
; Anders, Jepsson
and Andreas, Martinsson
- organization
-
- Heparin bindning protein in cardiothoracic surgery (research group)
- Bleeding disorders and acute typ-A dissection (research group)
- Minimal invasive cardiac surgery in valvular heart disease (research group)
- Thoracic Surgery
- Cardiology
- Electrocardiology Research Group - CIEL (research group)
- Arrhytmias and Cardiac Device treatment (research group)
- Neurological injury in acute type A aortic dissection (research group)
- publishing date
- 2023-09-09
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Journal of Thoracic and Cardiovascular Surgery
- volume
- 16
- pages
- 276 - 289
- publisher
- Mosby-Elsevier
- external identifiers
-
- scopus:85173144824
- pmid:38204629
- ISSN
- 1097-685X
- DOI
- 10.1016/j.xjon.2023.08.017
- language
- English
- LU publication?
- yes
- id
- 73e56d19-e21f-4929-9fcc-cb796a282aa5
- date added to LUP
- 2023-08-14 22:28:10
- date last changed
- 2024-04-02 03:00:08
@article{73e56d19-e21f-4929-9fcc-cb796a282aa5,
abstract = {{Objective<br/>Tricuspid annuloplasty is associated with increased risk of atrioventricular block and subsequent implantation of a permanent pacemaker. However, the exact incidence of permanent pacemaker, associated risk factors, and outcomes in this frame remain debated. The aim of the study was to report permanent pacemaker incidence, risk factors, and outcomes after tricuspid annuloplasty from nationwide databases.<br/>Methods<br/>By using data from multiple Swedish mandatory national registries, all patients (n = 1502) who underwent tricuspid annuloplasty in Sweden from 2006 to 2020 were identified. Patients who needed permanent pacemaker within 30 days from surgery were compared with those who did not. The cumulative incidence of permanent pacemaker implantation was estimated. A multivariable logistic regression model was fit to identify risk factors of 30-day permanent pacemaker implantation. The association between permanent pacemaker implantation and long-term survival was evaluated with multivariable Cox regression.<br/>Results<br/>The 30-day permanent pacemaker rate was 14.2% (214/1502). Patients with permanent pacemakers were older (69.8 ± 10.3 years vs 67.5 ± 12.4 years, P = .012). Independent risk factors of permanent pacemaker implantation were concomitant mitral valve surgery (odds ratio, 2.07; 95% CI, 1.34-3.27), ablation surgery (odds ratio, 1.59; 95% CI, 1.12-2.23), and surgery performed in a low-volume center (odds ratio, 1.85; 95% CI, 1.17-2.83). Permanent pacemaker implantation was not associated with increased long-term mortality risk (adjusted hazard ratio, 0.74; 95% CI, 0.53-1.03).<br/>Conclusions<br/>This nationwide study demonstrated a high risk of permanent pacemaker implantation within 30 days of tricuspid annuloplasty. However, patients who needed a permanent pacemaker did not have worse long-term survival, and the cumulative incidence of heart failure and major adverse cardiovascular events was similar to patients who did not receive a permanent pacemaker.}},
author = {{Ragnarsson, Sigurdur and Taha, Amar and J Nielsen, Susanne and Amabile, Andrea and Geirsson, Arnar and Krane, Markus and Mortsell, David and Sjögren, Johan and Anders, Jepsson and Andreas, Martinsson}},
issn = {{1097-685X}},
language = {{eng}},
month = {{09}},
pages = {{276--289}},
publisher = {{Mosby-Elsevier}},
series = {{Journal of Thoracic and Cardiovascular Surgery}},
title = {{Pacemaker implantation following tricuspid valve annuloplasty: A SWEDEHEART study}},
url = {{http://dx.doi.org/10.1016/j.xjon.2023.08.017}},
doi = {{10.1016/j.xjon.2023.08.017}},
volume = {{16}},
year = {{2023}},
}