BACKGROUND Permanent right ventricular pacing (RVP) results in cardiac dyssynchrony that may lead to heart failure and may be an indication for the use of cardiac resynchronization therapy (CRT). The study aimed to evaluate predictors of outcomes in patients with pacing-induced cardiomyopathy (PICM) if upgraded to CRT. METHODS One hundred fifteen patients, 75.0 years old (IQR 67.0-80.0), were upgraded to CRT due to the decline in left ventricle ejection fraction (LVEF) caused by the long-term RVP. A retrospective analysis was performed using data from hospital and outpatient clinic records and survival data from the National Health System. RESULTS The prior percentage of RVP was 100.0% (IQR 97.0-100.0), with a QRS duration of 180.0 ms (IQR 160.0-200.0). LVEF at the time of the upgrade procedure was 27.0% (IQR 21.0-32.75). The mean follow-up was 980 ± 522 days. The primary endpoint, death from any cause, was met by 26 (22%) patients. Age > 82 years (HR 5.96; 95% CI 2.24-15.89; P = .0004) and pre-CRT implantation LVEF < 20% (HR 5.63; 95%CI 2.19-14.47; P = .0003), but neither the cardioverter-defibrillator (ICD) implantation (HR 1.00; 95%CI 0.45-2.22; P = 1.00), nor the presence of atrial fibrillation (HR 1.22; 95%CI 0.56-2.64; P = .62), were independently associated with all-cause mortality. CONCLUSION Advanced age and an extremely low LVEF, but neither the presence of atrial fibrillation nor implanting an additional high voltage lead, influence the all-cause mortality in patients after long-term RVP, when upgraded to CRT.

中文翻译：

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起搏诱发的心肌病升级为CRT的患者的生存并不取决于除颤疗法。

背景技术永久性右心室起搏（RVP）导致心脏不同步，这可能导致心力衰竭，并且可能指示使用心脏再同步治疗（CRT）。这项研究旨在评估起搏诱发的心肌病（PICM）升级为CRT后的预后指标。方法115例75.0岁（IQR 67.0-80.0）的患者因长期RVP导致左心室射血分数（LVEF）下降而升级为CRT。使用来自医院和门诊诊所记录的数据以及来自国家卫生系统的生存数据进行回顾性分析。结果先前的RVP百分比为100.0％（IQR 97.0-100.0），QRS持续时间为180.0 ms（IQR 160.0-200.0）。升级过程时的LVEF为27.0％（IQR 21.0-32.75）。平均随访时间为980±522天。主要终点是由于任何原因导致的死亡，已有26位（22％）患者得到了满足。年龄> 82岁（HR 5.96; 95％CI 2.24-15.89; P = .0004）和CRT植入前LVEF <20％（HR 5.63; 95％CI 2.19-14.47; P = .0003），但两者均没有除颤器（ICD）植入（HR 1.00; 95％CI 0.45-2.22; P = 1.00）或房颤的存在（HR 1.22; 95％CI 0.56-2.64; P = 0.62）与所有患者均独立相关-造成死亡率。结论高龄和左室射血分数极低，但升级为CRT后，长期RVP后患者的全因死亡率不会影响房颤的发生或植入额外的高压导线。P = .0004）和CRT前植入LVEF <20％（HR 5.63; 95％CI 2.19-14.47; P = .0003），但都没有植入心脏复律除颤器（ICD）（HR 1.00; 95％CI 0.45- 2.22； P = 1.00）或房颤的存在（HR 1.22； 95％CI 0.56-2.64； P = 0.62）均与全因死亡率相关。结论高龄和左室射血分数极低，但升级为CRT后，长期RVP后患者的全因死亡率不会影响房颤的发生或植入额外的高压导线。P = .0004）和CRT前植入LVEF <20％（HR 5.63; 95％CI 2.19-14.47; P = .0003），但都没有植入心脏复律除颤器（ICD）（HR 1.00; 95％CI 0.45- 2.22； P = 1.00）或房颤的存在（HR 1.22； 95％CI 0.56-2.64； P = 0.62）均与全因死亡率相关。结论高龄和左室射血分数极低，但升级为CRT后，长期RVP后患者的全因死亡率不会影响房颤的发生或植入额外的高压导线。与全因死亡率独立相关。结论高龄和左室射血分数极低，但升级为CRT后，长期RVP后患者的全因死亡率不会影响房颤的发生或植入额外的高压导线。与全因死亡率独立相关。结论高龄和左室射血分数极低，但升级为CRT后，长期RVP后患者的全因死亡率不会影响房颤的发生或植入额外的高压导线。