Dataset Information

Aetiologies and temporal trends of atrioventricular block in young patients: a 20-year nationwide study.

ABSTRACT:

Aims

To describe aetiologies and temporal trends in young patients with atrioventricular block (AVB).

Methods and results

We identified all patients in Denmark, receiving their first pacemaker because of AVB before the age of 50?years between 1996 and 2015. Medical records were reviewed and clinical information and diagnostic work-up results were obtained to evaluate the aetiology. We used Poisson regression testing for temporal trends. One thousand and twenty-seven patients were identified, median age at time of implantation was 38 (interquartile range 25-45) years, 584 (56.9%) were male. The aetiologies were complications to cardiac surgery [n?=?157 (15.3%)], congenital AVB [n?=?93 (9.0%)], cardioinhibitory reflex [n?=?52 (5.0%)], congenital heart disease [n?=?43 (4.2%)], complication to radiofrequency ablation [n?=?35 (3.4%)], cardiomyopathy [n?=?31 (3.0%)], endocarditis [n?=?18 (1.7%)], muscular dystrophy [n?=?14 (1.4%)], ischaemic heart disease [n?=?14 (1.4%)], sarcoidosis [n?=?11 (1.1%)], borreliosis [n?=?9 (0.9%)], hereditary [n?=?6 (0.6%)], side-effect to antiarrhythmics [n?=?6 (0.6%)], planned His-ablation [n?=?5 (0.5%)], complication to alcohol septal ablation [n?=?5 (0.5%)], and other known aetiologies [n?=?11 (1.1%)]. The aetiology remained unknown in 517 (50.3%) cases. While the number of patients with unknown aetiology increased during the study period (P?ConclusionIn a nationwide cohort, the aetiology of AVB was identified in only half the patients younger than 50?years referred for first-time pacemaker implantation. The number of patients with unknown aetiology increased during the study period. These findings indicate need for better insight into aetiologies of AVB and improved diagnostic work-up guidelines.

SUBMITTER: Rudbeck-Resdal J

PROVIDER: S-EPMC6826204 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Publications

Aetiologies and temporal trends of atrioventricular block in young patients: a 20-year nationwide study.

Rudbeck-Resdal Johnni J Christiansen Morten K MK Johansen Jens B JB Nielsen Jens C JC Bundgaard Henning H Jensen Henrik K HK

Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology 20191101 11

<h4>Aims</h4>To describe aetiologies and temporal trends in young patients with atrioventricular block (AVB).<h4>Methods and results</h4>We identified all patients in Denmark, receiving their first pacemaker because of AVB before the age of 50 years between 1996 and 2015. Medical records were reviewed and clinical information and diagnostic work-up results were obtained to evaluate the aetiology. We used Poisson regression testing for temporal trends. One thousand and twenty-seven patients were ...[more]

PMID: 31424500

Similar Datasets

Project description:ImportancePacemaker implantations as a treatment for atrioventricular (AV) block are increasing worldwide. Prevention strategies for AV block are lacking because modifiable risk factors have not yet been identified.ObjectiveTo identify risk factors for AV block in community-dwelling individuals.Design, setting, and participantsIn this population-based cohort study, data from the Mini-Finland Health Survey, conducted from January 1, 1978, to December 31, 1980, were used to examine demographics, comorbidities, habits, and laboratory and electrocardiographic (ECG) measurements as potential risk factors for incident AV block. Data were ascertained during follow-up from January 1, 1987, through December 31, 2011, using a nationwide registry. A total of 6146 community-dwelling individuals were included in the analysis performed from January 15 through April 3, 2018.Main outcomes and measuresIncidence of AV block (hospitalization for second- or third-degree AV block).ResultsAmong the 6146 participants (3449 [56.1%] women; mean [SD] age, 49.2 [12.9] years), 529 (8.6%) had ECG evidence of conduction disease and 58 (0.9%) experienced a hospitalization with AV block. Older age (hazard ratio [HR] per 5-year increment, 1.34; 95% CI, 1.16-1.54; P < .001), male sex (HR, 2.04; 95% CI, 1.19-3.45; P = .01), a history of myocardial infarction (HR, 3.54; 95% CI, 1.33-9.42; P = .01), and a history of congestive heart failure (HR, 3.33; 95% CI, 1.10-10.09; P = .03) were each independently associated with AV block. Two modifiable risk factors were also independently associated with AV block. Every 10-mm Hg increase in systolic blood pressure was associated with a 22% higher risk (HR, 1.22; 95% CI, 1.10-1.34; P = .005), and every 20-mg/dL increase in fasting glucose level was associated with a 22% higher risk (HR, 1.22; 95% CI, 1.08-1.35; P = .001). Both risk factors remained statistically significant (HR for systolic blood pressure, 1.26 [95% CI, 1.06-1.49; P = .007]; HR for glucose level, 1.22 [95% CI, 1.04-1.43; P = .01]) after adjustment for major adverse coronary events during the follow-up period. In population-attributable risk assessment, an estimated 47% (95% CI, 8%-67%) of AV blocks may have been avoided if all participants exhibited ideal blood pressure and 11% (95% CI, 2%-21%) may have been avoided if all had a normal fasting glucose level.Conclusions and relevanceIn this analysis of data from a population-based cohort study, suboptimal blood pressure and fasting glucose level were associated with AV block. These results suggest that a large proportion of AV blocks are assocated with these risk factors, even after adjusting for other major adverse coronary events.

Dataset Information

Aetiologies and temporal trends of atrioventricular block in young patients: a 20-year nationwide study.

Aims

Methods and results

Publications

Aetiologies and temporal trends of atrioventricular block in young patients: a 20-year nationwide study.

Similar Datasets

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