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Cited by 155Cardiac Valve Diseases and TreatmentsCardiac pacing and defibrillation studiesCongenital Heart Disease Studies

Development and validation of a simple risk score to predict the need for permanent pacing after cardiac valve surgery

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Koplan, Bruce A, Stevenson, William G, Epstein, Laurence M, Aranki, Sary F, Maisel, William H·2003·Journal of the American College of Cardiology
DOI 10.1016/s0735-1097(02)02926-1
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Abstract

Objectives The study objective was to develop and validate a simple risk score to predict postoperative permanent pacing (PPM) after valve surgery. Background Our ability to identify patients preoperatively that will require PPM is poor. A simple preoperative risk score to predict PPM after valve surgery could assist both clinical practice and research. Methods All valve surgery patients at our institution from 1992 to 2002 were included (n = 4,694). Two-thirds of the patients were randomly selected to form a risk score prediction group (PG), and the score was then applied to the remaining patients (validation group [VG]). Results Preoperative right bundle branch block (odds ratio [OR], 3.6; 95% confidence interval [CI], 2.3 to 5.7) and multivalve surgery that included the tricuspid valve (OR, 3.7; 95% CI, 2.3 to 6.1) were the strongest independent predictors of PPM, while multivalve surgery that did not include the tricuspid valve (OR, 2.1; 95% CI, 1.3 to 3.3), preoperative left bundle branch block (OR, 2.0; 95% CI, 1.3 to 2.9), preoperative PR interval >200 ms (OR, 1.9; 95% CI, 1.3 to 3.0), prior valve surgery (OR, 1.8, 95% CI, 1.2 to 2.7), and age >70 years (OR, 1.4; 95% CI, 1.04 to 2.0) also predicted PPM. A risk score from 0 to 6 identified patients in the VG with incidences of PPM of 1.9%, 5.2%, 8.7%, 11.5%, 21%, 36%, and 50%, respectively. Conclusions A simple risk score incorporating preoperative conduction, age, prior valve surgery, and surgery type predicts PPM after valve surgery. This score may be useful in the perioperative management of valve surgery patients.

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  • Cardiac surgery, in particular valve surgery, carries risk of AV block requiring a permanent pacemaker.

    “Cardiac surgery, in particular valve surgery, also carries risk of AV block requiring a permanent pacemaker [28] .”

    From Evaluating and managing bradycardia (2020) · cites this paper as [28]

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Authors
Koplan, B. A., Stevenson, W. G., Epstein, L. M., Aranki, S. F., & Maisel, W. H.
Affiliations
Brigham and Women's Hospital (US)
Corresponding author
Koplan, Bruce A
ORCID
Venue
Journal of the American College of Cardiology
Publisher
Elsevier BV
Published
2003-03
Volume
41
Issue
5
Pages
795-801
ISSN
0735-1097 (ISSN-L)
DOI
10.1016/s0735-1097(02)02926-1
OpenAlex
W2116027757
Cited by
155
References
22
Citations by year
2026: 3 · 2025: 4 · 2024: 7 · 2023: 4 · 2022: 8 · 2021: 8 · 2020: 11 · 2019: 6 · 2018: 7 · 2017: 4 · 2016: 7 · 2015: 4 · 2014: 15 · 2012: 12
FWCI
1.35
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of the American College of Cardiology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Valve Diseases and Treatments
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
  • Health Sciences › Medicine › Epidemiology › Congenital Heart Disease Studies
Keywords
permanent cardiac pacing, heart valve surgery, risk score, preoperative prediction, right bundle branch block, left bundle branch block, tricuspid valve, conduction abnormalities, PR interval, age, perioperative care
MeSH terms
Aged, Female, Follow-Up Studies, Heart Valve Diseases, Heart Valve Prosthesis, Humans, Male, Middle Aged, Pacemaker, Artificial, Postoperative Complications, Predictive Value of Tests, Preoperative Care, Probability, Retrospective Studies, Risk Factors, Reproducibility of Results, Cohort Studies, Prevalence, Multivariate Analysis, Logistic Models, Treatment Outcome, Risk Assessment, Heart Valve Prosthesis Implantation, Needs Assessment

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