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PERMANENT PACEMAKER USE AND OUTCOMES IN OLDER PATIENTS WITH HEART FAILURE AND PRESERVED EJECTION FRACTION
A860 JACC April 1, 2014 Volume 63, Issue 12
Heart Failure and Cardiomyopathies Permanent Pacemaker Use and Outcomes in Older Patients with Heart Failure and Preserved Ejection Fraction Poster Contributions Hall C Sunday, March 30, 2014, 9:45 a.m.-10:30 a.m.
Session Title: Heart Failure and Cardiomyopathies: Therapy III Abstract Category: 14. Heart Failure and Cardiomyopathies: Therapy Presentation Number: 1185-164 Authors: Prateeti Khazanie, Anne Hellkamp, Gregg Fonarow, Lesley Curtis, Adrian Hernandez, Duke Clinical Research Institute, Durham, NC, USA, Duke University Medical Center, Durham, NC, USA Background: Patients with heart failure (HF) and preserved ejection fraction (PEF) may receive permanent pacemakers (PPMs) due to chronotropic incompetence and arrhythmias. Little is known about the prevalence and associated characteristics of PPM use in this population or outcomes compared to no PPMs. Methods: We analyzed patients with HF-PEF (LVEF >40%) from the ADHERE Registry from 2001-2006 linked with Medicare claims. We used Cox proportional hazards models to examine the associations between any PPM use and all-cause mortality, cardiovascular and HF rehospitalization after adjustment for covariates. We also examined associations in subgroups of patients by atrial fibrillation (AF) status, age ≥ 80, race, and sex. Results: Among 13,881 HF-PEF patients, 18.0% had PPMs at admission and 1.4% were implanted during the index hospitalization. PPM use was more common among older (81 vs 79 yrs, P<.001) males (38% vs 34%, P<.001) with AF (58% vs 36%, P<.001) and wider QRS duration (140ms vs 94ms, P<.001) compared to no PPM. After multivariable adjustment, there were no significant differences in mortality for patients with and without PPMs (Table); cardiovascular and HF rehospitalizations were higher among patients who received PPMs compared to those who did not. Subgroup analysis results were similar. Conclusions: PPM use is common among patients with HF-PEF and is associated with similar mortality and higher rehospitalizations compared to no PPM.
Heart Failure and Cardiomyopathies Permanent Pacemaker Use and Outcomes in Older Patients with Heart Failure and Preserved Ejection Fraction Poster Contributions Hall C Sunday, March 30, 2014, 9:45 a.m.-10:30 a.m.
Session Title: Heart Failure and Cardiomyopathies: Therapy III Abstract Category: 14. Heart Failure and Cardiomyopathies: Therapy Presentation Number: 1185-164 Authors: Prateeti Khazanie, Anne Hellkamp, Gregg Fonarow, Lesley Curtis, Adrian Hernandez, Duke Clinical Research Institute, Durham, NC, USA, Duke University Medical Center, Durham, NC, USA Background: Patients with heart failure (HF) and preserved ejection fraction (PEF) may receive permanent pacemakers (PPMs) due to chronotropic incompetence and arrhythmias. Little is known about the prevalence and associated characteristics of PPM use in this population or outcomes compared to no PPMs. Methods: We analyzed patients with HF-PEF (LVEF >40%) from the ADHERE Registry from 2001-2006 linked with Medicare claims. We used Cox proportional hazards models to examine the associations between any PPM use and all-cause mortality, cardiovascular and HF rehospitalization after adjustment for covariates. We also examined associations in subgroups of patients by atrial fibrillation (AF) status, age ≥ 80, race, and sex. Results: Among 13,881 HF-PEF patients, 18.0% had PPMs at admission and 1.4% were implanted during the index hospitalization. PPM use was more common among older (81 vs 79 yrs, P<.001) males (38% vs 34%, P<.001) with AF (58% vs 36%, P<.001) and wider QRS duration (140ms vs 94ms, P<.001) compared to no PPM. After multivariable adjustment, there were no significant differences in mortality for patients with and without PPMs (Table); cardiovascular and HF rehospitalizations were higher among patients who received PPMs compared to those who did not. Subgroup analysis results were similar. Conclusions: PPM use is common among patients with HF-PEF and is associated with similar mortality and higher rehospitalizations compared to no PPM.