Changes of postoperative ventricular pacing ratio and predictors of high pacing rate in patients with implantable cardioverter defibrillator

Abstract

Objective The prevalence, predictors, and survival for the development of pacing dependence in patient with implantable cardioverter defibrillator (ICD) are unknown. Methods This was a retrospective analysis of 213 consecutive patients with home-monitor ICD implantation at Centr of Arrhythmia in Fuwai Hospital from June 2010 to December 2017 with a mean of (3.1±1.9) years. Patients with pacing indication and malfunction of home-monitor system were excluded leaving 182 patients in this study. Accumulated ventricular pacing (VP) ≥40% was defined as the high pacing ratio. End point events included dead, heart transplantation, left ventricular assistant device (LVAD) implantation, and device upgrade. The patients were appraised six months after implantation and every year. Multivariate regression and Cox proportional hazard models were used for analysis. Results The mean age was (55.9±14.3) years. 77.5% were male with a primary indication for ICD in30.8%. VP≥40% occurred in 50 (27.4%) of patients, with a mean time (1.6±1.3) years. VP≥40% was associated with a 2.8-time increased odds for end point events (95%CI1.56-5.03, P<0.001) . Multivariate regression analysis demonstrated that older age, low ejection friction, and low basic heart rate were the strongest predictors for the high VP. Conclusion In this single-center ICD cohort, the high VP in ICD was not uncommon and was associated with decreased survival. Key words: Defibrillators, implantable; Cardiac pacing, artificial; Survival