Arrhythmias & electrophysiology
Dual-chamber vs. single-chamber pacemaker in patients in sinus rhythm with an atrioventricular block: a nationwide cohort study
Main finding · All-cause mortalityResult — go to the resultHazard ratio 0.807Authors' conclusion
Implantation of a dual-chamber pacemaker is associated with a lower risk of mortality, heart failure, atrial fibrillation, and stroke during follow-up.
Study context
- Population
- Patients with primary pacemaker implantation for complete atrioventricular block (AVB) with underlying sinus rhythm, France, January 2013–December 2022matched cohort
- Participants
- 19,219 vs 19,219
- Exposure
- Dual-chamber vs single-chamber pacemaker
- Dual-chambern = 19,219
- Single-chambern = 19,219reference
- Outcome
- All-cause mortality
Methodological detailspropensity-score matched, nationwide, national administrative database
- Propensity-score matched
- Nationwide
- National administrative database
Main finding
As reported in the abstract
Hazard ratio
0.807
P < 0.0001
By group
Dual-chamber
9.22%/year
Single-chamber
11.48%/year
Observational data: associations, not effects.
Further findings
| Outcome | HR | P value |
|---|---|---|
| CV mortality, HF, AF, ischaemic strokeDual-chamber vs Single-chamber · CV mortality | 0.766 | P < 0.0001 |
| CV mortality, HF, AF, ischaemic strokeDual-chamber vs Single-chamber · HF | 0.908 | P < 0.0001 |
| CV mortality, HF, AF, ischaemic strokeDual-chamber vs Single-chamber · AF | 0.778 | P < 0.0001 |
| CV mortality, HF, AF, ischaemic strokeDual-chamber vs Single-chamber · ischaemic stroke | 0.873 | P = 0.008 |
Safety
| Outcome | HR | P value |
|---|---|---|
| Re-interventions and complicationsDual-chamber vs Single-chamber · upgrades (addition of atrial or LV lead), fewer | 0.210 | P < 0.0001 |
| Re-interventions and complicationsDual-chamber vs Single-chamber · haematomas, more | 1.179 | P = 0.006 |
| Re-interventions and complicationsDual-chamber vs Single-chamber · lead repositioning, more | 1.123 | P = 0.04 |
Original publication
Dual-chamber vs. single-chamber pacemaker in patients in sinus rhythm with an atrioventricular block: a nationwide cohort study. Europace. Published 13 September 2024. doi:10.
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