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Stephen Padilla, 6 days ago
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Systolic blood pressure appears to have a strong association with aneurysmal subarachnoid haemorrhage (aSAH) but not with unruptured intracranial aneurysm (UIA), whereas current smoking and female sex are risk factors for both conditions, a study has found.

Pacemaker implantation after mitral valve surgery tied to higher risk of 1-year mortality

22 May 2019

The risk factors and outcomes associated with an increased risk of permanent pacing include atrial fibrillation (AF) ablation, multivalve surgery and New York Heart Association (NYHA) functional class III/IV, a recent study has found.

In addition, permanent pacemaker (PPM) implantation following mitral valve surgery (MVS) appears to increase the risk of 1-year mortality.

The investigators randomized 243 patients with AF and without previous PPM placement to MVS alone (n=117) or MVD + ablation (n=126). Those assigned to the ablation group were further randomized to pulmonary vein isolation (PVI; n=62) or the biatrial maze procedure (n=64). Competing risk models were utilized to examine the association among PPM and baseline and operative risk factors, as well as the effect of PPM on time to discharge, readmissions and 1-year mortality.

Of the patients, 35 (14.4 percent) received a PPM within the first year, and 29 (83 percent) of these recipients underwent implantation during the index hospitalization. PPM implantation was most frequent in patients randomized to MVS + biatrial maze (25 percent), followed by MVS + PVI (16.1 percent) and MVS alone (7.7 percent).

There were similar indications for PPM among patients who underwent MVS with and without ablation. Ablation, multivalve surgery and NYHA functional class III/IV were independently associated with PPM implantation.

Patients who received PPMs had a longer length of stay after surgery, but this was nonsignificant when adjusted for randomization assignment (MVS vs ablation) and age (hazard ratio [HR], 0.81; 95 percent CI, 0.61–1.08; p=0.14). PPM implantation did not increase the rate of 30-day readmissions (HR, 1.43; 0.50–4.05; p=0.50).

After adjustment for randomization assignment, age and NYHA functional class, an association was observed between the need for PPM and a higher risk of 1-year mortality (HR, 3.21; 1.01–10.17; p=0.05).

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Most Read Articles
Stephen Padilla, 6 days ago
Early administration of recombinant human B-type natriuretic peptide (rhBNP) can lower the incidence of reperfusion injury for patients with ST-elevation myocardial infarction (STEMI) who are receiving percutaneous coronary intervention (PCI) treatment, according to a China study.
11 Aug 2019
Intraoperative methylprednisolone does not appear to significantly prevent the incidence of death, cardiac arrest and other injuries in neonates undergoing cardiac surgery with cardiopulmonary bypass, according to a recent study.
2 days ago
Pulmonary function has potential predictive value for future increases in arterial stiffness and its progression, as reported in a recent study.
Yesterday
Systolic blood pressure appears to have a strong association with aneurysmal subarachnoid haemorrhage (aSAH) but not with unruptured intracranial aneurysm (UIA), whereas current smoking and female sex are risk factors for both conditions, a study has found.