"Preventive" pacing in patients with tachy-brady syndrome (TBS): Confirming a common practice.
Journal
International journal of clinical practice
ISSN: 1742-1241
Titre abrégé: Int J Clin Pract
Pays: India
ID NLM: 9712381
Informations de publication
Date de publication:
Oct 2020
Oct 2020
Historique:
received:
27
02
2020
accepted:
08
06
2020
pubmed:
14
6
2020
medline:
27
1
2021
entrez:
14
6
2020
Statut:
ppublish
Résumé
Many tachy-brady syndrome (TBS) patients, are implanted a permanent pacemaker (PPM) to allow continuation of anti-arrhythmic drug (AAD) therapy to maintain sinus rhythm. Many of these PPM's are implanted as a preventive measure, in absence of symptomatic bradycardia. Our primary aim was to evaluate pacing use among these patients and find predictors for PPM use. Our secondary aim was to appreciate the portion of these patients who progress to permanent atrial fibrillation (AF). Retrospective study of TBS patients implanted a PPM as preventive measure, dividing cases into defined categories regarding highest percent atrial and ventricular pacing documented in PPM clinic visits during 3 year follow-up (F/U) period. Patients' baseline characteristics and AAD therapy were compared between cases with a major (>90%) pacing use and cases with <90% pacing use to find predictors for pacing use. Multivariable logistic regression was applied to identify independent variables associated with major pacing use. Our study included 119 TBS patients. Most (86.5%) TBS patients had a moderate (>50%) pacing use and 58% had a major pacing use. Significant association was found between pre-implant severe sinus bradycardia (<40 bpm), first degree atrioventricular block and amiodarone treatment to major pacing use on univariate analysis and severe sinus bradycardia was significantly associated with major pacing on multivariate analysis as well. Only minority (16.8%) of TBS patients progressed to permanent AF during the study F/U period. Our study reveals most TBS patients succeed to maintain sinus rhythm using an AAD with a significant pacing use, suggesting preventive PPM implantation might be advantageous in these cases. Pre-implant severe sinus bradycardia (<40 bpm) is a possible predictor for major pacing use in this population.
Substances chimiques
Anti-Arrhythmia Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e13583Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2020 John Wiley & Sons Ltd.
Références
Shaw DB, Holman RR, Gowers JI. Survival in sino atrial disorder (sick-sinus syndrome). BMJ. 1980;1980:139-141.
Adán V, Crown LA. Diagnosis and treatment of sick sinus syndrome. Am Fam Physician. 2003;67:1725-1732.
Brignole M, Auricchio A, Baron-Esquivias G, et al. Guidelines on cardiac pacing and cardiac resynchronization therapy: the Task Force on cardiac pacing and resynchronization therapy of the European Society of Cardiology (ESC) developed in collaboration with the European Heart Rhythm Association (EHRA). Eur Heart J. 2013;34:2281-2329.
Kusumoto FM, Schoenfeld MH, Barrett C, et al. ACC/AHA/HRS guideline on the evaluation and management of patients with bradycardia and cardiac conduction delay: a Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Heart Rhythm. 2018;2018:S5147-S5271.
Kaplan BM, Langendorf R, Lev M, Pick A. Tachycardia-bradycardia syndrome (so-called “sick sinus syndrome”): pathology, mechanisms and treatment. Am J Cardiol. 1973;31:497-508.
Fuster V, Harrington RA, Narula J, Eapen ZJ. Hurst’s the Heart 2017 (14th edition); Section 13: Rhythm and Conduction Disorders. New York, NY: McGraw-Hill Education; 2017.
Tse G, Liu T, Li KHC, et al. Tachycardia-bradycardia syndrome: Electrophysiological mechanisms and future therapeutic approaches (Review). Int J Mol Med. 2017;39:519-526.
Lamas GA, Lee K, Sweeney M, et al. The mode selection trial (MOST) in sinus node dysfunction: design, rationale, and baseline characteristics of the first 1000 patients. Am Heart J. 2000;140:541-551.
Alboni P, Menozzi C, Brignole M, et al. Effects of permanent pacemaker and oral theophylline in sick sinus syndrome the THEOPACE study: a randomized controlled trial. Circulation. 1997;96:260-266.
Mangrum JM, DiMarco JP. The evaluation and management of bradycardia. N Engl J Med. 2000;342:703-709.
Ovsyshcher IE, Barold SS. Drug induced bradycardia: to pace or not to pace? Pacing Clin Electrophysiol. 2004;27:1144-1147.
Zipes DP. Proarrhythmic effects of antiarrhythmic drugs. Am J Cardiol. 1987;59:26E-31E.
Israel CW, Barold SS. Treatment of tachyarrhythmia with pacing and antiarrhythmic drugs. In: Advances in the Treatment of Atrial Tachyarrhythmias. Armonk, NY: Futura; 2002:305-323.
Chung MK, Schweikert RA, Wilkoff BL, et al. Is hospital admission for initiation of antiarrhythmic therapy with sotalol for atrial arrhythmias required? Yield of in-hospital monitoring and prediction of risk for significant arrhythmia complications. J Am Coll Cardiol. 1998;32:169-176.
Roy D, Talajic M, Dorian P, et al. Amiodarone to prevent recurrence of atrial fibrillation. Canadian Trial of Atrial Fibrillation Investigators. N Engl J Med. 2000;342:913-920.
Essebag V, Hadjis T, Platt RW, Pilote L. Amiodarone and the risk of bradyarrhythmia requiring permanent pacemaker in elderly patients with atrial fibrillation and prior myocardial infarction. J Am Coll Cardiol. 2003;41:249-254.
Hauser TH, Pinto DS, Josephson ME, Zimetbaum P. Safety and feasibility of a clinical pathway for the outpatient initiation of antiarrhythmic medications in patients with atrial fibrillation or atrial flutter. Am J Cardiol. 2003;91:1437-1441.
Barrett TW, Abraham RL, Jenkins CA, Russ S, Storrow AB, Darbar D. Risk factors for bradycardia requiring pacemaker implantation in patients with atrial fibrillation. Am J Cardiol. 2012;110:1315-1321.
Hohnloser SH, Healey JS, Gold MR, et al. Atrial overdrive pacing to prevent atrial fibrillation: Insights from the ASSERT Trial. Heart Rhythm. 2012;9:1667-1673.
Padeletti L, Purerfellner H, Mont L, et al. New generation atrial antitachycardia pacing (Reactive ATP) is associated with reduced risk of persistent or permanent atrial fibrillation in patients with bradycardia: results from the MINERVA randomized multicenter international study. Heart Rhythm. 2015;12:1717-1725.
Kirchhof P, Benussi S, Kotecha D, et al. The Task Force for the management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. 2016 ESC guidelines for the management of atrial fibrillation developed in collaboration with the EACTS. Europace. 2016;18:1609-1678.