AI Article Synopsis

  • The study focused on non-ischemic symptomatic reversible bradyarrhythmia, a condition that can be often misunderstood in clinical settings, aiming to determine how often it recurs and the predictors for needing permanent cardiac pacing.
  • It included 124 adults monitored for up to 24 months after conservative treatment, finding that 21.8% required permanent pacing due to recurrence, with common causes being certain medications and high potassium levels.
  • Key predictors for needing pacing included advanced atrioventricular block and bifascicular block observed during the patient's initial hospitalization, highlighting the need for closer monitoring and potential intervention.

Article Abstract

Objective: Non-ischemic symptomatic reversible bradyarrhythmia is a poorly characterized yet common clinical challenge. This study aimed to assess the incidence and predictors of recurrence and the need for permanent cardiac pacing in patients with non-ischemic symptomatic reversible bradyarrhythmia.

Methods: This prospective single-center study enrolled 124 consecutive adult patients with non-ischemic symptomatic reversible bradyarrhythmia who were followed up for up to 24 months after conservative management during index hospitalization. The primary endpoint was a recurrence of bradyarrhythmia requiring permanent cardiac pacing. The secondary endpoint was a composite of recurrence requiring permanent pacing, readmission, or death. Univariate and multivariate analyses were conducted to determine the predictors of the endpoints.

Results: Sinus node and atrioventricular node diseases were seen in 66.1% and 33.9% of patients, respectively. The most common causes of bradyarrhythmia were negative chronotropic drugs (58.1%) and hyperkalemia (55.6%). Permanent pacing was required in 21.8% of patients after a recurrence. Advanced atrioventricular block at presentation (HR: 6.10, 95% CI: 2.45-15.20,  < 0.001) and bifascicular block at discharge (HR: 3.63, 95% CI: 1.58-8.33,  = 0.002) during index hospitalization were significant independent predictors of recurrence requiring cardiac pacing.

Conclusion: Non-ischemic symptomatic reversible bradyarrhythmia is associated with a high risk of recurrence. Permanent cardiac pacing should be considered during index hospitalization in patients with advanced atrioventricular block and/or bifascicular block.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11496075PMC
http://dx.doi.org/10.3389/fcvm.2024.1455018DOI Listing

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Article Synopsis
  • The study focused on non-ischemic symptomatic reversible bradyarrhythmia, a condition that can be often misunderstood in clinical settings, aiming to determine how often it recurs and the predictors for needing permanent cardiac pacing.
  • It included 124 adults monitored for up to 24 months after conservative treatment, finding that 21.8% required permanent pacing due to recurrence, with common causes being certain medications and high potassium levels.
  • Key predictors for needing pacing included advanced atrioventricular block and bifascicular block observed during the patient's initial hospitalization, highlighting the need for closer monitoring and potential intervention.
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