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ORIGINAL RESEARCH article

Front. Cardiovasc. Med.
Sec. Cardiac Rhythmology
Volume 11 - 2024 | doi: 10.3389/fcvm.2024.1455018

Recurrence Rate and Predictors in Non-Ischemic Reversible Bradyarrhythmia

Provisionally accepted
Sudhanshu K. Dwivedi Sudhanshu K. Dwivedi 1Akhil Kumar Sharma Akhil Kumar Sharma 1*Anant Agrawal Anant Agrawal 2Kapil Doomra Kapil Doomra 3Gaurav K. Chaudhary Gaurav K. Chaudhary 1Sharad Chandra Sharad Chandra 1Monika Bhandari Monika Bhandari 1Pravesh Vishwakarma Pravesh Vishwakarma 1Akshyaya Pradhan Akshyaya Pradhan 1Rishi Sethi Rishi Sethi 1Ayush Shukla Ayush Shukla 1Abhishek Singh Abhishek Singh 1Safal Safal Safal Safal 4
  • 1 King George's Medical University, Lucknow, Uttar Pradesh, India
  • 2 Rhythm Heart Institute, Vadodra, Gujarat, India
  • 3 Shalby Hospital, Mohali, India, Mohali, India
  • 4 Gobind Ballabh Pant Hospital, New Delhi, National Capital Territory of Delhi, India

The final, formatted version of the article will be published soon.

    Objective: Non-ischemic symptomatic reversible bradyarrhythmia is a poorly characterized common clinical challenge. This study aimed to assess the incidence and predictors of recurrence and need for permanent cardiac pacing in patients with non-ischemic symptomatic reversible bradyarrhythmia.Methods: Prospective single-center study of consecutive 124 adult patients presenting with non-ischemic symptomatic reversible bradyarrhythmia who were followed up for up to 24 months after conservative management during index hospitalization. Primary endpoint was a recurrence of bradyarrhythmia requiring permanent cardiac pacing. Secondary endpoint was a composite of recurrence requiring permanent pacing, readmission, or death. Univariate and multivariate analyses were done to determine the predictors of the endpoints.Results: Sinus node and atrioventricular node disease was seen in 66.1% and 33.9% patients, respectively. Most common causes for bradyarrhythmia were negative chronotropic drugs (58.1%) and hyperkalemia (55.6%). Permanent pacing was required in 21.8% patients after a recurrence. Advanced atrioventricular block at presentation (HR: 6.10, 95% CI: 2.45-15.20, p <0.001) and bifascicular block at discharge (HR: 3.63, 95% CI: 1.58-8.33, p=0.002) during index hospitalization were significant independent predictors of recurrence requiring cardiac pacing.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.

    Keywords: Atrioventricular node dysfunction, sinus node dysfunction, reversible bradyarrhythmia, Permanent pacemaker implantation, Outcome

    Received: 26 Jun 2024; Accepted: 28 Aug 2024.

    Copyright: © 2024 Dwivedi, Sharma, Agrawal, Doomra, Chaudhary, Chandra, Bhandari, Vishwakarma, Pradhan, Sethi, Shukla, Singh and Safal. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Akhil Kumar Sharma, King George's Medical University, Lucknow, 226003, Uttar Pradesh, India

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.