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ȣ - 530761 172 |
The clinical course of bradyarrhythmias treated with temporary pacemaker: the causes and their prognosis |
Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea |
이재범, 이만영, 고훈영, 황희정, 정종원, 최윤석, 박철수, 오용석, 윤호중, 노태호, 김재형 |
Background: Bradyarrhythmias may be presented as a serious emergency condition. The incidence, cause, and prognosis of the bradyarrhythmias requiring the temporary pacemaker (TP) are not well studied in Korea.
Methods: In this retrospective study, TPs were inserted in 161 patients (M:F=74:87, mean age = 70 ± 12 years) at ER between Jan 1999 and Jun 2009. We divided the patients into two groups; group 1 [n= 80, treated with permanent pacemaker (PM)] and group 2 (n=81, treated without PM), and searched the clinical characteristics, causes and the ECG patterns of bradyarrhythmias in the two groups.
Results: There were no significant differences in clinical characteristics between two groups. In Group 1, the common cause of bradyarrhythmias was idiopathic (n=74, 92.5%) and coronary artery disease (CAD) (n=6, 7.5%). The most common ECG pattern was complete AV block (56.3%). (Table 1) In Group 2, the causes of the bradyarrhythmias were as follows; CADs (n=46, 56.8%), drug related (n=15, 18.5%), hyperkalemia (n=9, 11.1%), unknown (n=8, 9.9%), and each of sepsis with hypotension, shock with ulcer bleeding, myocarditis in 1 patient (1.2%) respectively. Among the CAD group, the common ECG patterns were complete AV block (n=22, 44.3%), junctional escape (n=16, 30.8%) and sinus bradycardia (n=11, 21.2%).
Conclusions: The most common underlying cause was idiopathic. However, in reversible cases, CAD was the main underlying cause. The evaluation of CAD is necessary in patients with severe bradyarrhythmia
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Table 1, Comparison of ECG pattern in bradyarrhythmia between two groups |
ECG pattern |
Group 1 (n=80) |
Group 2 (n=81) |
Junctional escape rhythm |
13 (16.3%) |
33 (40.7%) |
Tachy-bradycardia syndrome |
7 (8.8%) |
2 (2.5%) |
Sinus bradycardia |
9 (11.3%) |
12 (14.8%) |
Atrial fibrillation with SVR |
0 (0%) |
6 (7.4%) |
2nd AV block, Mobitz type 2 |
4 (5.0%) |
2 (2.5%) |
Advanced AV block |
2 (2.5%) |
0 (0%) |
Complete AV block |
45 (56.3%) |
26 (32.1)) |
*SVR, slow ventricular rhythm |
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