TY - JOUR
T1 - Clinical Predictors of Pacing Device Implantation in Implantable Cardiac Monitor Recipients for Unexplained Syncope
AU - Tonegawa-Kuji, Reina
AU - Inoue, Yuko Y.
AU - Nakai, Michikazu
AU - Kanaoka, Koshiro
AU - Sumita, Yoko
AU - Miyazaki, Yuichiro
AU - Wakamiya, Akinori
AU - Shimamoto, Keiko
AU - Ueda, Nobuhiko
AU - Nakajima, Kenzaburo
AU - Kataoka, Naoya
AU - Wada, Mitsuru
AU - Yamagata, Kenichiro
AU - Ishibashi, Kohei
AU - Miyamoto, Koji
AU - Nagase, Satoshi
AU - Aiba, Takeshi
AU - Miyamoto, Yoshihiro
AU - Iwanaga, Yoshitaka
AU - Kusano, Kengo
N1 - Publisher Copyright:
© 2022 The Authors
PY - 2023/4
Y1 - 2023/4
N2 - Background: Implantable cardiac monitors (ICMs) help investigate the cause of unexplained syncope, but the probability and predictors of needing a pacing device thereafter remain unclear. Methods: We retrospectively analyzed the data of patients who received ICM insertion for unexplained syncope with suspected arrhythmic etiology. The data were obtained from a nationwide database obtained between April 1, 2012 and March 31, 2020. Multivariable mixed-effects survival analysis was performed to identify predictors of pacing device implantation (PDI), and a risk score model was developed accordingly. Results: In total, 2905 patients (age: 72 years [range: 60-78]) implanted with ICMs to investigate the cause of syncope were analyzed. During the median follow-up period of 128 days (range: 68–209) days, 473 patients (16%) underwent PDI. Older age, history of atrial fibrillation, bundle branch block (BBB), and diabetes were independent predictors of PDI in multivariable analysis. A risk score model was developed with scores ranging from 0 to 32 points. When patients with the lowest quartile score (0–13 points) were used as a reference, those with higher quartiles had a higher risk of PDI (second quartile: 14–15 points, hazard ratio [HR]: 3.86, 95% confidence interval [CI]: 2.62–5.68; third quartile: 16–18 points, HR: 4.67, 95% CI: 3.14–6.94; fourth quartile: 19–32 points, HR: 6.59, 95% CI: 4.47–9.71). Conclusions: The 4 identified predictors are easily assessed during the initial evaluation of patients with syncope. They may help identify patients with a higher risk of requiring permanent PDI.
AB - Background: Implantable cardiac monitors (ICMs) help investigate the cause of unexplained syncope, but the probability and predictors of needing a pacing device thereafter remain unclear. Methods: We retrospectively analyzed the data of patients who received ICM insertion for unexplained syncope with suspected arrhythmic etiology. The data were obtained from a nationwide database obtained between April 1, 2012 and March 31, 2020. Multivariable mixed-effects survival analysis was performed to identify predictors of pacing device implantation (PDI), and a risk score model was developed accordingly. Results: In total, 2905 patients (age: 72 years [range: 60-78]) implanted with ICMs to investigate the cause of syncope were analyzed. During the median follow-up period of 128 days (range: 68–209) days, 473 patients (16%) underwent PDI. Older age, history of atrial fibrillation, bundle branch block (BBB), and diabetes were independent predictors of PDI in multivariable analysis. A risk score model was developed with scores ranging from 0 to 32 points. When patients with the lowest quartile score (0–13 points) were used as a reference, those with higher quartiles had a higher risk of PDI (second quartile: 14–15 points, hazard ratio [HR]: 3.86, 95% confidence interval [CI]: 2.62–5.68; third quartile: 16–18 points, HR: 4.67, 95% CI: 3.14–6.94; fourth quartile: 19–32 points, HR: 6.59, 95% CI: 4.47–9.71). Conclusions: The 4 identified predictors are easily assessed during the initial evaluation of patients with syncope. They may help identify patients with a higher risk of requiring permanent PDI.
UR - http://www.scopus.com/inward/record.url?scp=85149660603&partnerID=8YFLogxK
U2 - 10.1016/j.cjco.2022.12.007
DO - 10.1016/j.cjco.2022.12.007
M3 - 学術論文
C2 - 37124961
AN - SCOPUS:85149660603
SN - 2589-790X
VL - 5
SP - 259
EP - 267
JO - CJC Open
JF - CJC Open
IS - 4
ER -