BACKGROUND It has previously been described that fall-associated injuries including fractures are commonly observed among patients with bradyarrhythmia.However,knowledge on the risk of pacemaker implantation after adm...BACKGROUND It has previously been described that fall-associated injuries including fractures are commonly observed among patients with bradyarrhythmia.However,knowledge on the risk of pacemaker implantation after admission due to femur fracture from large population-based epidemiologic data is lacking.Therefore,we investigated the risk of pacemaker implanta-tion following femur fracture in patients with and without a history of previous syncope.METHODS All patients with femur fracture between 2005-2017 were identified using the Danish Nationwide Patient Registry.Among these,patients already having a pacemaker were excluded.Primary outcome was one-year risk of pacemaker implanta-tion and secondary outcome was one-year all-cause mortality.Multivariable logistic regression was used to obtain absolute and relative risks of the study endpoint in relation to patients with versus without history of syncope and standardized to the age,sex,selected comorbidity and pharmacotherapy distribution of all patients.RESULTS Of 93,093 patients with femur fracture,5508(5.9%)had a history of syncope within five years.Patients with prior syn-cope were slightly older(84 vs.83 years),more often male(33.6%vs.29.4%),and had more often comorbidities relative to those without history of syncope.All-cause mortality was significantly higher among those with previous history of syncope com-pared to those without previous syncope(29.9%vs.28.6%,P=0.021).The relative mortality risk was 1.05(95%CI:1.01−1.09,P=0.021).A total of 695(0.8%)patients underwent pacemaker implantation within 5 years following femur fracture,and a signific-antly higher proportion of patients with syncope had a pacemaker implanted within one year(1.6%vs.0.7%,P<0.001;relative risk,2.01[95%CI:1.55−2.46]).CONCLUSIONS In patients with femur fracture,a history of syncope was significantly associated with a higher one-year risk of pacemaker implantation.展开更多
OBJECTIVES To investigate complications within 30-days following first-time ablation for atrial fibrillation(AF),including a composite of cardiac tamponade,hematoma requiring intervention,stroke or death,in patients≥...OBJECTIVES To investigate complications within 30-days following first-time ablation for atrial fibrillation(AF),including a composite of cardiac tamponade,hematoma requiring intervention,stroke or death,in patients≥75 years of age,compared to pa-tients aged 65−74 years.In addition,one-year all-cause mortality and AF relapse were compared.METHODS&RESULTS All patients receiving their first catheter ablation for AF between 2012 and 2016 were identified us-ing Danish nationwide registries.Patients aged 65−74 years served as the reference group for patients≥75 years.Relapse of AF within one year was defined as cardioversion following a three-month blanking period,re-ablation or confirmed relapse within follow-up.The composite complication outcome did not differ between the two age groups,with 39/1554(2.8%)in patients 65−74 years of age,versus 5/199(2.5%)in older patients(adjusted HR=0.94),95%CI:0.37−2.39,P=0.896).Patients≥75 years or older had no increased hazard of death within 30 days after the procedure,with an incidence of 3/1554(0.2%)in younger pa-tients and 2/199(1.0%)in patients≥75 years of age(adjusted HR=4.71,95%CI:0.78−28.40,P=0.091).There was no difference in relapse of AF after one year between age groups(≥75 years adjusted HR=1.00,95%CI:0.78-1.26,P=0.969).CONCLUSION In patients≥75 years of age selected for catheter ablation for AF,the incidence of periprocedural complica-tions,as well as one-year freedom from AF showed no statistical difference,when compared to patients 65−74 years of age.展开更多
文摘BACKGROUND It has previously been described that fall-associated injuries including fractures are commonly observed among patients with bradyarrhythmia.However,knowledge on the risk of pacemaker implantation after admission due to femur fracture from large population-based epidemiologic data is lacking.Therefore,we investigated the risk of pacemaker implanta-tion following femur fracture in patients with and without a history of previous syncope.METHODS All patients with femur fracture between 2005-2017 were identified using the Danish Nationwide Patient Registry.Among these,patients already having a pacemaker were excluded.Primary outcome was one-year risk of pacemaker implanta-tion and secondary outcome was one-year all-cause mortality.Multivariable logistic regression was used to obtain absolute and relative risks of the study endpoint in relation to patients with versus without history of syncope and standardized to the age,sex,selected comorbidity and pharmacotherapy distribution of all patients.RESULTS Of 93,093 patients with femur fracture,5508(5.9%)had a history of syncope within five years.Patients with prior syn-cope were slightly older(84 vs.83 years),more often male(33.6%vs.29.4%),and had more often comorbidities relative to those without history of syncope.All-cause mortality was significantly higher among those with previous history of syncope com-pared to those without previous syncope(29.9%vs.28.6%,P=0.021).The relative mortality risk was 1.05(95%CI:1.01−1.09,P=0.021).A total of 695(0.8%)patients underwent pacemaker implantation within 5 years following femur fracture,and a signific-antly higher proportion of patients with syncope had a pacemaker implanted within one year(1.6%vs.0.7%,P<0.001;relative risk,2.01[95%CI:1.55−2.46]).CONCLUSIONS In patients with femur fracture,a history of syncope was significantly associated with a higher one-year risk of pacemaker implantation.
文摘OBJECTIVES To investigate complications within 30-days following first-time ablation for atrial fibrillation(AF),including a composite of cardiac tamponade,hematoma requiring intervention,stroke or death,in patients≥75 years of age,compared to pa-tients aged 65−74 years.In addition,one-year all-cause mortality and AF relapse were compared.METHODS&RESULTS All patients receiving their first catheter ablation for AF between 2012 and 2016 were identified us-ing Danish nationwide registries.Patients aged 65−74 years served as the reference group for patients≥75 years.Relapse of AF within one year was defined as cardioversion following a three-month blanking period,re-ablation or confirmed relapse within follow-up.The composite complication outcome did not differ between the two age groups,with 39/1554(2.8%)in patients 65−74 years of age,versus 5/199(2.5%)in older patients(adjusted HR=0.94),95%CI:0.37−2.39,P=0.896).Patients≥75 years or older had no increased hazard of death within 30 days after the procedure,with an incidence of 3/1554(0.2%)in younger pa-tients and 2/199(1.0%)in patients≥75 years of age(adjusted HR=4.71,95%CI:0.78−28.40,P=0.091).There was no difference in relapse of AF after one year between age groups(≥75 years adjusted HR=1.00,95%CI:0.78-1.26,P=0.969).CONCLUSION In patients≥75 years of age selected for catheter ablation for AF,the incidence of periprocedural complica-tions,as well as one-year freedom from AF showed no statistical difference,when compared to patients 65−74 years of age.
