Evidence map›Paper›PMID 36549180›Full record

ArticleJournal of electrocardiology

Electrocardiographic parameters associated with pacemaker induced cardiomyopathy.

Zak Loring, Anna Giczewska, Paul Hofmann, Karen Chiswell, Todd T Schlegel, Martin Ugander, Kevin P Jackson, Jonathan P Piccini, Brett D Atwater

Abstract read
In one paragraph

Article in Journal of electrocardiology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Zak LoringDuke Clinical Research Institute, Durham, NC, USA; Division of Cardiology, Department of Medicine, Duke University, Durham, NC, USA. Electronic address: zak.loring@duke.edu.
Anna GiczewskaDuke Clinical Research Institute, Durham, NC, USA.
Paul HofmannDuke Clinical Research Institute, Durham, NC, USA.
Karen ChiswellDuke Clinical Research Institute, Durham, NC, USA.
Todd T SchlegelNicollier-Schlegel SARL, Trelex, Vaud, Switzerland; Department of Clinical Physiology, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.
Martin UganderDepartment of Clinical Physiology, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden; Kolling Institute, Royal North Shore Hospital, University of Sydney, Sydney, Australia.
Kevin P JacksonDivision of Cardiology, Department of Medicine, Duke University, Durham, NC, USA.
Jonathan P PicciniDuke Clinical Research Institute, Durham, NC, USA; Division of Cardiology, Department of Medicine, Duke University, Durham, NC, USA.
Brett D AtwaterInova Heart and Vascular Institute, Falls Church, VA, USA.

Funding

Postdoctoral Training in Cardiovascular Clinical ResearchT32HL069749 · NHLBI · DUKE UNIVERSITY · PI MARK, DANIEL B · 2003 to 2023
$6.7M
Neurocognition and Greater Maintenance of Sinus Rhythm in AF (NOGGIN AF)R01AG074185 · NIA · DUKE UNIVERSITY · PI MATHEW, JOSEPH P, PICCINI, JONATHAN PAUL · 2021 to 2025
$3.7M
NHLBI NIH HHS T32 HL069749NIA NIH HHS R01 AG074185
6 · The paper itself

Abstract

backgroundChronic right ventricular (RV) pacing can induce left ventricular (LV) dyssynchrony and cause pacemaker induced cardiomyopathy (PiCM). Identifying which patients are at risk for PiCM is limited.

methodsPatients receiving RV-only permanent pacemakers (PPMs) at Duke University Medical Center between 2011 and 2017 who had normal baseline ejection fractions (EFs) were identified. Patients who developed a subsequent decrease in EF, died, or underwent cardiac resynchronization therapy, left ventricular assist device, or heart transplant without a competing cause were considered as the primary endpoint. Pre-PPM and post-PPM electrocardiograms (ECGs) were analyzed to extract scalar measurements including the lead one ratio (LOR) as well as advanced-ECG (A-ECG) features to identify predictors of PiCM. Traditional and penalized Cox regression were used to identify variables predictive of the primary endpoint.

resultsPre-PPM ECGs were evaluated for 404 patients of whom 140 (35%) experienced the primary endpoint. Predictors included female sex (hazard ratio [HR] 1.14), a T' wave in V6 (HR 1.31), a P' wave in aVL (HR 0.88), and estimated glomerular filtration rate (HR 0.88). Post-PPM ECGs were evaluated for 228 patients for whom 94 (41%) experienced the primary endpoint. Predictors included female sex (HR 0.50), age (HR 1.06), and a history of congestive heart failure (HR 1.63). Neither LOR nor A-ECG parameters were strong predictors of the primary endpoint.

conclusionsBaseline and paced ECG data provide limited insight into which patients are at high risk for developing PiCM.

Indexed as

Cardiac Resynchronization TherapyCardiomyopathiesHeart FailurePacemaker, ArtificialCardiac Pacing, ArtificialElectrocardiographyFemaleHumansVentricular Function, LeftCardiomyopathyElectrocardiographyPacemakers

Identifiers

PMID36549180
PMCPMC11140723

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.