Prognostic Value of Temporary Pacemaker Insertion in Patients with Acute Myocardial Infarction in the Era of Percutaneous Coronary Revascularization

作者全名："Wang, Peng; Wang, Shidong; Liu, Zhimin; Song, Lei; Xu, Bo; Dou, Kefei; Wu, Yongjian; Qiao, Shubin; Gao, Runlin; Zhao, Gang; Huang, Mi; Hu, Xuemei; Wang, Hao; Xu, Xuelian; Yang, Yuejin"

作者地址："[Wang, Peng; Liu, Zhimin; Song, Lei; Xu, Bo; Dou, Kefei; Wu, Yongjian; Qiao, Shubin; Gao, Runlin; Yang, Yuejin] Chinese Acad Med Sci & Peking Union Med Coll, Fuwai Hosp, Natl Ctr Cardiovasc Dis, Beijing 100037, Peoples R China; [Wang, Shidong] Linyi Peoples Hosp Shandong Prov, Dept Cardiol, Dezhou 251500, Shandong, Peoples R China; [Zhao, Gang; Huang, Mi; Hu, Xuemei; Xu, Xuelian] Chongqing Med Univ, Univ Town Hosp, Dept Cardiol, Chongqing 401331, Peoples R China; [Wang, Hao] Chongqing Univ Ctr Hosp, Chongqing Emergency Med Ctr, Dept Cardiovasc Med, Chongqing 400014, Peoples R China"

通信作者："Yang, YJ (通讯作者)，Chinese Acad Med Sci & Peking Union Med Coll, Fuwai Hosp, Natl Ctr Cardiovasc Dis, Beijing 100037, Peoples R China.; Xu, XL (通讯作者)，Chongqing Med Univ, Univ Town Hosp, Dept Cardiol, Chongqing 401331, Peoples R China."

来源：REVIEWS IN CARDIOVASCULAR MEDICINE

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001025509200005

JCR分区：Q3

影响因子：1.9

年份：2023

卷号：24

期号：6

开始页：　

结束页：　

文献类型：Article

关键词：acute myocardial infarction (AMI); arrhythmia; temporary pacemaker (tPM); coronary revascularization

摘要："Background: Patients with acute myocardial infarction (AMI) complicated with arrhythmia are not uncommon. Insertion of temporary pacemakers (tPMs) in patients with arrythmia during acute myocardial infarction (AMI) is imperative support therapy. Arrhythmias include high-degree atrioventricular block (AVB), sinus arrest/bradycardia, and ventricular arrythmia storm. To date, no study has eval-uated the prognosis of tPMs in patients with AMI complicated with arrhythmia. Especially in the era of thrombolysis or emergency percutaneous coronary intervention (PCI) for coronary artery revascularization, our study was designed to investigate the value of tPMs implantation in cases of AMI complicated with various arrhythmias. Methods: From January 2009 to January 2019, 35,394 patients with AMI, including 62.0% (21,935) with ST-segment elevation myocardial infarction (STEMI) and 38.0% (13,459) with non-ST-segment elevation myocardial infarction (NSTEMI) in four hospitals, were reviewed. A total of 552 patients with AMI associated with arrythmia were included in the cohort. Among the 552 patients, there were 139 patients with tPM insertions. The incidence trend of myocardial infarction complicated with various arrhythmias in the past 10 years was analysed, and the clinical characteristics, in-hospital mortality, postdischarge mortality, composite endpoints of modality, and independent risk factors were compared in patients with and without tPM in the era of coronary artery revascularization. Results: In patients with AMI-associated arrythmia, high-degree AVB was the major cause of tPM insertion (p = 0.045). In the past 10 years, the number of patients with high-degree AVB, tPM implantation, ventricular arrythmia storm, and in-hospital mortality has decreased year by year in the era of coronary artery revascularization. In the tPM group, the culprit vessel was the left main artery, and cardiogenic shock, acute renal injury and high brain natriuretic peptide (BNP) levels were independent risk factors for patients with AMI complicated with arrhythmia. The in-hospital mortality in the tPM group was higher than that in the non-tPM group. The patients with tPM insertion showed better postdischarge survival than patients without tPM insertion. Conclusions: In the era of emergency thrombolysis or PCI, coronary revascularization can ameliorate the prognosis of patients with AMI complicated with various arrhythmias. Temporary pacemaker insertion in patients with AMI complicated with arrhythmia can reduce the postdischarge mortality of these patients."

基金机构：Science and Technol-ogy Research Program of Chongqing Municipal Education Commission [KJQN201800406]; Chongqing Science and health joint project [2020GDRC020]

基金资助正文：Funding This work was supported by the Science and Technol-ogy Research Program of Chongqing Municipal Education Commission (Grant No. KJQN201800406) . This work was supported by Chongqing Science and health joint project (Grant No. 2020GDRC020) .