Parsova Kemal Emrecan, Hayiroglu Mert Ilker, Pay Levent, Cinier Goksel, Gurkan Kadir
Department of Cardiology, Zile State Hospital, Tokat, Turkey.
Department of Cardiology, University of Health Sciences, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Selimiye Mahallesi, Tıbbiye Caddesi, No: 13, Uskudar, 34668, Istanbul, Turkey.
Egypt Heart J. 2022 Aug 1;74(1):56. doi: 10.1186/s43044-022-00297-3.
Most of the patients hospitalized due to drug-related atrioventricular (AV) block do not require permanent pacemaker implantation (PPI) since AV block regresses following cessation of the responsible drug. However, AV block requiring PPI may relapse in long-term follow-up. In this study, we retrospectively evaluated the factors predicting the need for a PPI in the long-term follow-up in patients admitted to our hospital with drug-related AV block but did not require PPI in index hospitalization.
We evaluated 177 patients who had been hospitalized with drug-related AV block between January 2012 and July 2020 and who had not required PPI during hospital follow-up. The patients were divided into two groups according to whether PPI was performed or not. The independent predictors of long-term PPI were evaluated and the effect of glomerular filtration rate (GFR) of the patients during the index hospitalization on the long-term outcome was compared. A GFR above 60 ml/min is an independent significant risk factor in predicting long-term permanent pacemaker implantation in drug-related AV blocks. It is found that the need for PPI was 2.64 times higher without adjusted and 1.9 times higher with adjusted for all covariates in patients with GFR above 60 ml/min during hospitalization compared to those with GFR below 30 ml/min.
GFR may be considered as an indicator of the PPI need in patients with drug-related atrioventricular AV block.
大多数因药物相关的房室传导阻滞住院的患者，在停用相关药物后房室传导阻滞消退，无需植入永久性起搏器（PPI）。然而，需要PPI的房室传导阻滞在长期随访中可能会复发。在本研究中，我们回顾性评估了我院因药物相关房室传导阻滞住院但在首次住院时无需PPI的患者在长期随访中预测PPI需求的因素。
我们评估了2012年1月至2020年7月期间因药物相关房室传导阻滞住院且在住院随访期间无需PPI的177例患者。根据是否进行PPI将患者分为两组。评估长期PPI的独立预测因素，并比较患者在首次住院期间的肾小球滤过率（GFR）对长期结局的影响。GFR高于60 ml/min是预测药物相关房室传导阻滞长期植入永久性起搏器的独立显著危险因素。结果发现，住院期间GFR高于60 ml/min的患者与GFR低于30 ml/min的患者相比，未调整时PPI需求高2.64倍，调整所有协变量后高1.9倍。
GFR可被视为药物相关房室传导阻滞患者PPI需求的一个指标。
