Periprocedural cardiac troponin elevation: A potential indicator of enhanced ventricular threshold in permanent pacemaker recipients
Küçük Resim Yok
Tarih
2017
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Scientific Publishers of India
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Background and aim: Permanent cardiac pacing is the most efficient treatment for patients with symptomatic bradycardia and high-degree atrioventricular (AV) block. For effective pacing, sensing and pacemaker battery longevity; ventricular pacing threshold (VPT) levels, lead impedance levels and R-wave amplitude levels must be desirable. We aimed to search the association between elevated serum troponin levels and VPT values in patients who has implanted single chamber permanent pacemaker. Materials and methods: We retrospectively analyzed a total of 109 patients (mean age: 78 ± 7.1 years, 53.6% male) who underwent single chamber permanent pacemaker implantation for indications such high-degree atrioventricular block and sick sinus syndrome. Hematological and biochemical parameters were measured prior to pacemaker implantation. Additionally troponin I and high-sensitivity C-reactive protein (hs-CRP) were sampled about 12 hours after pacemaker implantation. Results: Over a median follow-up period of 17.3 months, 32 (29.3%) patients has positive troponin I levels after implantation. Troponin positive group has higher VPT values at the time of implantation (0.94 ± 0.33 vs. 0.71 ± 0.19, p<0.001) and at 30th day of implantation (0.69 ± 0.16 V vs. 0.91 ± 0.31 V, p<0.001). To identify in dependent risk factors for ventricular threshold values, a multivariate linear regression model was conducted and after implantation having positive troponin value (?=0.337, p=0.01) and troponin elevation ratio (?=0.365, p<0.001) were found to be independent risk factors for ventricular threshold. Conclusion: Our results indicate that troponin I elevation after pacemaker implantation is associated with higher VPT values at the time of and the 30th day of implantation. For longevity of pacemaker batteries, low threshold values are preferable. To further extend the life of pacemakers, we recommend following patients more closely who has high troponin levels after permanent pace replacement. © 2017, Scientific Publishers of India. All rights reserved.
Açıklama
Anahtar Kelimeler
Cardiac Pacemaker; Troponin; Ventricular Pacing Threshold, Acetylsalicylic Acid; Angiotensin Receptor Antagonist; C Reactive Protein; Dipeptidyl Carboxypeptidase Inhibitor; Diuretic Agent; Hydroxymethylglutaryl Coenzyme A Reductase Inhibitor; Troponin; Troponin I; Adult; Age Distribution; Article; Artificial Heart Pacemaker; Atrioventricular Block; Biochemistry; Cardiovascular Parameters; Cardiovascular Risk; Echocardiography; Female; Follow Up; Heart Ventricle Function; Hematological Parameters; Human; Major Clinical Study; Male; Patient Monitoring; Perioperative Period; Protein Analysis; Protein Blood Level; Retrospective Study; Risk Assessment; Risk Factor; Sex Difference; Sick Sinus Syndrome; Ventricular Pacing Threshold
Kaynak
Biomedical Research (India)
WoS Q Değeri
Scopus Q Değeri
N/A
Cilt
28
Sayı
8
