A Clinical Study: Risk Factors Of New-Onset Heart Failure After Right Ventricular Septal Pacing

Objective:To investigate the risk factors of new-onset heart failure after right ventricular septal(RVS)pacing in patients with normal left ventricular function.Methods:1.The study consisted of 133 consecutive patients with Atrioventricular(AV)block or sick sinus syndrome(SSS)and treated with permanent pacemaker implanation at the department of Cardiovascular disease,the Second Hospital of Hebei Medical University from January 2016 to December 2017.All patients had normal left ventricular function,and all the ventricular leads were set in RVS during the implantation.2.All patients were followed at our clinic at the first month,the third month,the sixth month,and the twelfth month after the implantation.During the follow up,patients presented with cardiac failure symptoms or impaired LV ejection fraction,based on echo-cardiogram,were included in the study group.Patients that did not presented new-onset heart failure(HF)during the follow up were included in the control group.A total of 81 patients were included in the final analysis.3.SPSS 19.0 software was used for statistical analysis.Continuous variables were expressed as mean ± 1 standard deviation.Statistical comparisons for continuous data were performed with Student's t-test,while comparisons for categorical data were performed with chi-squared test or Fisher's exact test,as appropriate.Multivariate Logistic regression analysis was used to examine the risk factors of new-onset of HF.P<0.05 was considered statistically significant.Results: The mean of the age of all patients was 68.82±10.91(39~90),and 36(44.44%)parients were male,43(53.10%)had hypertension,15(18.50%)had diabetes,18(22.20%)had coronary heart disease(CHD).During the initial pacemaker implantation,75(92.60%)patients received DDD and 6(7.40%)patients received VVI pacemaker.There were 4(80%)patients diagnosed with CHD and 4(80%)patients with AVB in study group,while 14(18.42%)patients diagnosed CHD and 33(43.42%)patients with AVB in control group,the difference in CHD prevalence was statistically significant(P<0.05)between two groups.No patients diagnosed with diabetes in the study group.In our study,there was no statistically difference in sex,age,pacing mode,paced QRS duration,baseline QRS duration,baseline LVEF%,baseline LV between two groups.However,uni-variable logistic regression analysis showed that the presence of CHD is a risk factor for new-onset HF.Conclusion:The prevalence of CHD was statistically different between two groups.The presence of CHD before pace maker implantation independently predicted the new-onset HF.