Factors Influencing Mortality in Patients with Pacemaker/ICD Dysfunction Presenting to Emergency Departments

Abstract

Aim: Management of patients with heart failure and implanted cardioverter defibrillators (ICDs) is as important as ICD placement. Inappropriate shocks and factors affecting mortality are the factors determining management. Appropriate intervention and detection improve the quality of life of patients. We aimed to investigate the complaints, medication use, electrocardiography findings, symptoms, laboratory findings and body mass index affecting mortality in patients with pacemaker/ICD dysfunction who presented to the emergency department. Materials and Methods: Our study is a single-center, prospective, observational cohort. It included patients aged 18 years and older with pacemakers of both genders who gave their consent between 09/01/2022 and 09/01/2023. Results: Ninety-one patients were included. The mean age was 65.02±13.71 years and 61 (67.0%) were male. The most common diseases were hypertension (86.8%) and congestive heart failure (76.9%). The most commonly used drugs were beta blockers (70.3%) and antiplatelet agents (59.3%). ICD shock rates were higher in men and those with dyspnea did not experience inappropriate ICD shocks. There was a significant correlation between in-hospital mortality and systolic blood pressure (BP), diastolic BP, partial oxygen saturation (sPO2) and potassium (K) levels. Conclusion: We found that ICD shock rates were higher in men and in patients without diabetes mellitus. The incidence of infection due to pacemaker/ICD use was low. We found that ICD patients with low partial sPO2 and hypotensive patients had a worse prognosis. We found that K levels above 4.65 mEq/L were associated with increased mortality.

Keywords

• body mass index
• emergency department
• implantable cardioverter defibrillators
• pacemaker
• pacemaker dysfunction.