Format

Send to

Choose Destination
J Am Coll Cardiol. 2014 Aug 12;64(6):531-8. doi: 10.1016/j.jacc.2014.03.056.

Incidence of and risk factors for sick sinus syndrome in the general population.

Author information

1
Cardiovascular Health Research Unit, University of Washington, Seattle, Washington; Department of Epidemiology, University of Washington, Seattle, Washington.
2
Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota.
3
Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota.
4
Department of Medicine, University of Maryland, Baltimore, Maryland.
5
Cardiovascular Health Research Unit, University of Washington, Seattle, Washington; Department of Epidemiology, University of Washington, Seattle, Washington; Department of Pharmacy, University of Washington, Seattle, Washington.
6
Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota. Electronic address: alonso@umn.edu.

Abstract

BACKGROUND:

Little is known about the incidence of and risk factors for sick sinus syndrome (SSS), a common indication for pacemaker implantation.

OBJECTIVES:

This study sought to describe the epidemiology of SSS.

METHODS:

This analysis included 20,572 participants (mean baseline age 59 years, 43% male) in the ARIC (Atherosclerosis Risk In Communities) study and the CHS (Cardiovascular Health Study), who at baseline were free of prevalent atrial fibrillation and pacemaker therapy, had a heart rate of ≥ 50 beats/min unless using beta blockers, and were identified as of white or black race. Incident SSS cases were identified by hospital discharge International Classification of Disease-revision 9-Clinical Modification code 427.81 and validated by medical record review.

RESULTS:

During an average 17 years of follow-up, 291 incident SSS cases were identified (unadjusted rate 0.8 per 1,000 person-years). Incidence increased with age (hazard ratio [HR]: 1.73; 95% confidence interval [CI]: 1.47 to 2.05 per 5-year increment), and blacks had a 41% lower risk of SSS than whites (HR: 0.59; 95% CI: 0.37 to 0.98). Incident SSS was associated with greater baseline body mass index, height, N-terminal pro-B-type natriuretic peptide, and cystatin C, with longer QRS interval, with lower heart rate, and with prevalent hypertension, right bundle branch block, and cardiovascular disease. We project that the annual number of new SSS cases in the United States will increase from 78,000 in 2012 to 172,000 in 2060.

CONCLUSIONS:

Blacks have a lower risk of SSS than whites, and several cardiovascular risk factors were associated with incident SSS. With the aging of the population, the number of Americans with SSS will increase dramatically over the next 50 years.

KEYWORDS:

epidemiology; pacemaker; sick sinus syndrome; tachy-brady syndrome

Comment in

PMID:
25104519
PMCID:
PMC4139053
DOI:
10.1016/j.jacc.2014.03.056
[Indexed for MEDLINE]
Free PMC Article

Publication types, MeSH terms, Grant support

Publication types

MeSH terms

Grant support

Supplemental Content

Full text links

Icon for Elsevier Science Icon for PubMed Central
Loading ...
Support Center