Arrhythmias & electrophysiologyMeta-analysis
Complications After Permanent Pacemaker Implantation in Patients with Congenital Complete Atrioventricular Block: A Systematic Review and Meta-analysis
- Systematic Review and Meta-analysis
- random-effect meta-analysis
Authors' conclusion
In CCAVB, permanent pacing is associated with a clinically meaningful, lifelong burden of cardiomyopathy, mortality, and device-related complications. The wide variation in outcome definitions and the largely retrospective evidence base limit firm conclusions, underscoring the need for prospective multicentre studies with standardized definitions.
Study context
- Population
- Patients with isolated or predominantly isolated congenital complete atrioventricular block (CCAVB) undergoing permanent pacemaker implantation, with ≥6 months' follow-uppaced patients, Eighteen studies
- Participants
- 1,233 patients
Pooled result
As reported in the abstract
Pooled incidence of pacing-induced cardiomyopathy (PICM)
13.3% (95% CI 9.9-17.7%; I2=68%)
Further pooled results
PICM onset · onset earlier in antibody-positive
P = 0.009
All-cause mortality
- All-cause mortality
- 6.3% (95% CI 3.8-10.3%; I2=75%)
PICM, sensitivity analyses across alternative definitions
- Similar estimates
- 12.1% to 13.4%
PICM incidence by length of follow-up
- Non-significant trend toward higher PICM incidence with longer follow-up
- β=+0.025 per year; p=0.080
Safety
Lead failure
- Lead failure
- 9.5% (95% CI 4.2-19.9%; I2=85%)
Device infection
- Device infection
- 8.2% (95% CI 4.4-15.0%; I2=49%)
- including deep/device-related infection
- 4.2% (95% CI 2.1-8.2%; I2=20%)
Original publication
Summarised from the published abstract; every number is checked against it