Predictors of improved quality of life 1 year after pacemaker implantation

Background Patient's health-related quality of life (HRQoL) of pacemaker (PM) patients has increasingly become an important issue of health care evaluation. Currently, knowledge of pacing performance and technology is more or less outlined. However, determinants of poor or good HRQoL of paced p...

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Bibliographic Details
Published in:The American heart journal 2008-09, Vol.156 (3), p.491-497
Main Authors: van Eck, J.W. Martijn, MD, van Hemel, Norbert M., MD, PhD, van den Bos, Arjan, MD, PhD, Taks, William, Grobbee, Diederick E., MD, PhD, Moons, Karel G.M., PhD
Format: Article
Language:English
Subjects:
Adult
Age
Aged
Aged, 80 and over
Atrial Fibrillation - complications
Atrial Fibrillation - therapy
Biological and medical sciences
Cardiac arrhythmia
Cardiac Pacing, Artificial
Cardiology. Vascular system
Cardiovascular
Cohort Studies
Disease
Female
Health Status
Heart Diseases - complications
Heart failure
Humans
Longitudinal Studies
Male
Medical sciences
Middle Aged
Mortality
Older people
Pacemaker, Artificial
Pain
Pathology
Predictive Value of Tests
Prospective Studies
Prostheses and Implants
Quality of Life
Questionnaires
Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)
Sinuses
Surveys and Questionnaires
Time Factors
Ventricular Dysfunction - complications
Ventricular Dysfunction - therapy
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Summary:Background Patient's health-related quality of life (HRQoL) of pacemaker (PM) patients has increasingly become an important issue of health care evaluation. Currently, knowledge of pacing performance and technology is more or less outlined. However, determinants of poor or good HRQoL of paced patients require further elucidation. Objectives The purpose of this study is to determine the HRQoL 1 year after PM implantation and predictors of differences in HRQoL between pre- and post-PM implantation. Methods We quantified the mean differences between HRQoL before implantation (baseline) and 1 year later, assessed with the generic Medical Outcomes Survey 36-Item Short-Form Survey and EuroQol (EQ5D), and the PM patient-specific AQUAREL (Assessment of QUality of life And RELated events) questionnaires, in 501 consecutively included patients in the Dutch multicenter longitudinal FOLLOWPACE cohort study. Multivariable linear regression modeling was then performed to determine predictive factors of the HRQoL 1 year after implantation. Results The HRQoL of the patients increased markedly in the first year after implantation. Seventy percent of the patients considered their health improved, whereas 11% experienced a complete recovery in HRQoL. The most important predictors for improved HRQoL after 1 year were HRQoL at baseline, age, presence of cardiac comorbidities, and atrial fibrillation with slow ventricular response as indication for chronic pacing. Conclusion In most patients receiving a PM, HRQoL increased in the first year after PM implantation. Knowledge of the predictors of this increase may aid physicians to timely differentiate between patients who most likely will benefit most from PM implantation in terms of HRQoL.
ISSN:0002-8703
1097-6744
DOI:10.1016/j.ahj.2008.04.029