Outcomes in Patients With Prolonged PR Interval or First-Degree Atrioventricular Block—Reply
- Susan Cheng, MDDivision of Cardiovascular MedicineBrigham and Women's HospitalBoston, Massachusetts;
- Thomas J. Wang, MD tjwang@partners.orgCardiology DivisionMassachusetts General HospitalBoston
Since this article does not have an abstract, we have provided the first 150 words of the full text.
- KEYWORDS:
- ATRIAL FIBRILLATION
- ATRIOVENTRICULAR BLOCK
- ELECTROCARDIOGRAPHY
- ELECTROCARDIOGRAPHY, AMBULATORY
- HYPERTROPHY, LEFT VENTRICULAR
- MORTALITY
- OUTCOME ASSESSMENT (HEALTH CARE)
- PACEMAKER, ARTIFICIAL
In Reply: Dr Oh and colleagues suggest adjusting for electrocardiographic LVH in our mortality analyses. When this variable was added as a covariate, we observed no change in the adjusted hazard ratio for mortality (1.08 per standard deviation increment in PR interval; 95% confidence interval, 1.02-1.13; P = .005). Although electrocardiographic LVH is a predictor of mortality, it was not significantly associated with PR interval in our data.
In response to Dr Doraiswamy, we note that 89% of the pacemakers were implanted for a primary indication of high-grade AV block or sinus node dysfunction. The other 11% were attributed to a variety of indications, including postoperative changes or myocardial infarction, with high-grade AV block or sinus node dysfunction often noted as a secondary indication. Analyses examining the relationship of specific conduction abnormalities with outcomes were limited by inadequate power. With regard to nodal-blocking agents, we excluded individuals using medications at baseline …
