Abstract 103: Determinants of Quality of Life in Permanent Pacemaker Patients: a Cross-Sectional Analysis

Background: Permanent pacemakers (PPM) have improved cardiovascular outcomes and quality of life (QoL) in patients with a wide variety of cardiac rhythm disturbances. Nevertheless, misperceptions about the safety of daily activities (SODA) and associated factors can compromise patients’ absolute well-being. We aimed to study factors associated with worst QoL in PPM patients. Methods: PPM patients from a tertiary hospital answered an 18-question questionnaire about their perception on the SODA, which was scored based on misperception rate. Patients also answered SF-36, a validated QoL questionnaire which is scored from 0 to 100 on each of its 8 scales. Baseline characteristics were compared to average on SF-36 scales in a cross-sectional model by t-test for categorical variables and by univariable regression for continuous variables. Statistical analysis was done with Stata software 10.0 (Texas). Results: A total of 75 PPM patients aged 65.3±12 years were included, of which 31 (41%) were males. Most common reason for PPM was 3rd degree atrioventricular block (44%). Body mass index (p=0.019) and misperception rate on SODA (p=0.003) presented a significant negative regression coefficient with SF-36 average. Age, gender, average income, Chagas disease etiology, diabetes, hypertension, ejection fraction, NYHA classification, previous myocardial infarction (MI), smoking history and peripheral vascular disease were not significantly associated with SF-36 QoL results. Conclusions: In a cross-sectional study, body mass index and misperceptions about the safety of daily-life activities were associated with worst quality of life in patients with permanent pacemaker. These results suggest that optimal physician education of patients and their families about the SODA for PPM patients may ultimately improve patients’ well-being

Abstract 105: Chagas Disease: an Independent Mortality Risk Factor for Patients with Pacemakers?

Background: Almost 25% of patients with Chagas disease (CD) have some degree of cardiac compromise, including rhythm disturbances, which ultimately may require permanent pacemaker (PPM) implantation. CD has been shown to be an independent risk factor for mortality in heart failure. In PPM patients the prognostic significance of CD seropositivity is yet to be determined. Methods: Patients from a highly endemic region for CD with a PPM were divided into two groups: those with CD confirmed by immunofluorescence and those without CD. Patients were followed for a 3-year period. Cox proportional-hazards model and Kaplan-Meier method with log-rank test for mortality were calculated. Results: A total of 75 patients aged 65.3±12 years were included, of which 31 (41%) were males and 49 (65%) had positive serology for CD. Age, gender, diabetes, hypertension, ejection fraction, reason for PPM implantation and prior myocardial infarction were not significantly different between groups. After a 3-year follow up, 8 patients in the CD group and 1 in the control group died. Although mortality rate was higher in patients with CD seropositivity, the difference was not statistically significant (HR 3.86; p=0.17). Kaplan-Meier survival plot is illustrated bellow. Conclusions: CD was associated with a non-significant increased mortality rate in PPM patients. Larger prospective studies may reveal a significant prognostic role for CD seropositivity in this population