School of Medicine, Georgetown University, Washington, DC 20057, USA.
Cardiol Res Pract. 2010;2010:310768. doi: 10.4061/2010/310768. Epub 2010 May 5.
Background. Right ventricular pacing (RVP) has been associated with adverse outcomes, including heart failure and death. Minimizing RVP has been proposed as a therapeutic goal for a variety of pacing devices and indications. Objective. Quantify survival according to frequency of RVP in veterans with pacemakers. Methods. We analyzed electrograms from transtelephonic monitoring of veterans implanted with pacemakers between 1995 and 2005 followed by the Eastern Pacemaker Surveillance Center. We compared all cause mortality and time to death between patients with less than 20% and more than 80% RVP. Results. Analysis was limited to the 7198 patients with at least six trans-telephonic monitoring records (mean = 21). Average follow-up was 5.3 years. Average age at pacemaker implant was significantly lower among veterans with <20% RVP (67 years versus 72 years; P < .0001). An equal proportion of deaths during follow-up were noted for each group: 126/565 patients (22%) with <20% RVP and 1113/4968 patients (22%) with >80% RVP. However, average post-implant survival was 4.3 years with <20% RVP versus 4.7 years with >80% RVP (P < .0001). Conclusions. Greater frequency (>80%) of RVP was not associated with higher mortality in this population of veterans. Those veterans utilizing <20% RVP had a shortened adjusted survival rate (P = .0016).
右心室起搏（RVP）与心力衰竭和死亡等不良结局相关。为了各种起搏设备和适应证，已经提出将最小化 RVP 作为治疗目标。目的：根据起搏器患者 RVP 的频率来量化生存率。方法：我们分析了 1995 年至 2005 年间接受起搏器植入的退伍军人的远程监测心电图，并由东部起搏器监测中心进行随访。我们比较了 RVP 小于 20%和大于 80%的患者的全因死亡率和死亡时间。结果：分析仅限于至少有 6 份远程监测记录的 7198 名患者（平均=21 份）。平均随访时间为 5.3 年。RVP 小于 20%的退伍军人的起搏器植入时年龄明显较低（67 岁对 72 岁；P <.0001）。随访期间每组的死亡比例相等：RVP 小于 20%的 565 名患者中有 126 名（22%），RVP 大于 80%的 4968 名患者中有 1113 名（22%）。然而，RVP 小于 20%的患者平均术后生存时间为 4.3 年，RVP 大于 80%的患者为 4.7 年（P <.0001）。结论：在这群退伍军人中，RVP 频率较高（>80%）与死亡率升高无关。那些 RVP 小于 20%的退伍军人的调整后生存率缩短（P=.0016）。
