TY - JOUR
T1 - Temporal trends in permanent pacemaker implantation
T2 - A population-based study
AU - Uslan, Daniel Z.
AU - Tleyjeh, Imad M.
AU - Baddour, Larry M.
AU - Friedman, Paul A.
AU - Jenkins, Sarah M.
AU - St Sauver, Jennifer L.
AU - Hayes, David L.
N1 - Funding Information:
This article was presented, in part, at the American Heart Association Scientific Sessions, November 2006, Chicago, Ill (Abstracts 3877 and 3878). This study was supported by the Division of Cardiovascular Diseases, Mayo Clinic College of Medicine, Rochester, Minn. The division had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript. Dr Uslan and Ms Jenkins had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
PY - 2008/5
Y1 - 2008/5
N2 - Background: Limited data exist regarding temporal trends in permanent pacemaker (PPM) implantation. To describe trends in incidence and comorbidities of PPM recipients, we conducted a retrospective population-based cohort study over a 30-year period. Methods: All 1291 adult residents of Olmsted County, Minnesota, undergoing PPM implantation between 1975 and 2004 were included in the study. Trends in PPM implantation incidence, pacing mode and indication, and comorbidities (via Charlson Comorbidity Index [CCI]) were assessed through the Rochester Epidemiology Project. Permanent pacemaker recipients were compared with age- and sex-matched PPM-free controls from the population. Results: Adjusted implantation incidence rates increased from 36.6 per 100 000 person-years during 1975 to 1979 to 99 per 100 000 person-years during 2000 to 2004 (P < .0001). After adjusting for age (hazard ratio [HR] 1.06 per year), male sex (HR 1.28), and implant year (HR 0.98), the HR for death among PPM recipients by CCI quartiles was 1.0, 1.79, 2.29, and 3.91 for CCI of 0 to 1 (reference), 2 to 3, 4 to 6, and ≥7, respectively (P < .0001). Overall, PPM recipients had higher CCI than the population-based controls (P = .04), with higher mean CCI noted since 1990. Mean age-adjusted CCI increased from 3.15 to 4.60 among the cases (P < .0001) and from 3.06 to 3.54 among the age- and sex-matched controls (P = .047). Conclusions: There have been significant increases in incidence of PPM implantation over 30 years, and PPM recipients have had an age-independent increase in comorbidities relative to the underlying population, especially over the past 15 years.
AB - Background: Limited data exist regarding temporal trends in permanent pacemaker (PPM) implantation. To describe trends in incidence and comorbidities of PPM recipients, we conducted a retrospective population-based cohort study over a 30-year period. Methods: All 1291 adult residents of Olmsted County, Minnesota, undergoing PPM implantation between 1975 and 2004 were included in the study. Trends in PPM implantation incidence, pacing mode and indication, and comorbidities (via Charlson Comorbidity Index [CCI]) were assessed through the Rochester Epidemiology Project. Permanent pacemaker recipients were compared with age- and sex-matched PPM-free controls from the population. Results: Adjusted implantation incidence rates increased from 36.6 per 100 000 person-years during 1975 to 1979 to 99 per 100 000 person-years during 2000 to 2004 (P < .0001). After adjusting for age (hazard ratio [HR] 1.06 per year), male sex (HR 1.28), and implant year (HR 0.98), the HR for death among PPM recipients by CCI quartiles was 1.0, 1.79, 2.29, and 3.91 for CCI of 0 to 1 (reference), 2 to 3, 4 to 6, and ≥7, respectively (P < .0001). Overall, PPM recipients had higher CCI than the population-based controls (P = .04), with higher mean CCI noted since 1990. Mean age-adjusted CCI increased from 3.15 to 4.60 among the cases (P < .0001) and from 3.06 to 3.54 among the age- and sex-matched controls (P = .047). Conclusions: There have been significant increases in incidence of PPM implantation over 30 years, and PPM recipients have had an age-independent increase in comorbidities relative to the underlying population, especially over the past 15 years.
UR - http://www.scopus.com/inward/record.url?scp=43049096406&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=43049096406&partnerID=8YFLogxK
U2 - 10.1016/j.ahj.2007.12.022
DO - 10.1016/j.ahj.2007.12.022
M3 - Article
C2 - 18440339
AN - SCOPUS:43049096406
SN - 0002-8703
VL - 155
SP - 896
EP - 903
JO - American heart journal
JF - American heart journal
IS - 5
ER -