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Death in patients with permanent pacemakers for sick sinus syndrome.

Abstract：

BACKGROUND:Although more than one million patients in the United States have permanent pacemakers, little is known about their cause of death. We evaluated the cause of death in 404 patients who died in the Mode Selection Trial (MOST). METHODS:In MOST, patients received a dual-chamber pacemaker randomly programmed to either dual-chamber or ventricular pacing. The circumstances surrounding each death were reviewed by a clinical events committee, which used prospectively defined criteria to adjudicate the cause of death. RESULTS:A total of 2010 patients with a median age of 74 years were included. After a median follow-up of 33 months, 404 (20%) patients died, including 198 (49%) of noncardiac causes and 143 (35.4%) of cardiac causes. In 63 patients, the cause of death was unknown. Independent predictors of death through the use of a multivariable analysis were (1) demographic factors including age, male sex, and weight; (2) clinical factors including prior myocardial infarction, cardiomyopathy, New York Heart Association class III/IV, and the Charlson Comorbidity Index; and (3) scores from two measures of functional status, the Karnofsky Score and the Mini-Mental State Examination. Independent predictors of cardiovascular death were similar. CONCLUSIONS:Patients treated with permanent pacemakers for sinus node dysfunction are elderly and have a substantial mortality rate, with more than half the classifiable deaths being noncardiac. Baseline demographic variables and scores from quality-of-life measures can identify patients with the highest risk of death.

journal_name

Am Heart J

journal_title

American heart journal

authors

Flaker G,Greenspon A,Tardiff B,Schron E,Goldman L,Hellkamp A,Lee K,Lamas G,Mode Selection Trial (MOST) Investigators.

doi

10.1016/S0002-8703(03)00429-0

subject

Has Abstract

pub_date

2003-11-01 00:00:00

pages

887-93

issue

5

eissn

0002-8703

issn

1097-6744

pii

S0002870303004290

journal_volume

146

pub_type

临床试验,杂志文章,多中心研究,随机对照试验

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