Patients with Implanted Permanent Pacemakers: Baseline Characteristics and Coronary Angiographic Profile

ABSTRACT Background: Etiology of severe cardiac conduction disturbances is frequently uncertain. The risk factors of both coronary artery disease and conduction defects often overlap. Considering this, the present study aimed to find the relationship between complete heart block and specific pathological coronary anatomy. Material and Methods: Seventy-eight patients, (39 patients with a permanent pacemaker and 39 matched control patients who underwent coronary angiography procedure) were studied. The lesions were classified into four types, according to the anatomy of blood supply to the different segments of the conduction system. Results: Type IV lesion was common in study group compared to matched control group where type III lesion was common. Lesions that compromise blood flow to septal branches (types II and IV) were common in study group and the lesion types that do not compromise blood flow (types I and III) were common in control group (p<0.001). Type 1 lesion were common in females (p<0.001). Type IV lesions were common in hypertensive, whereas, non- hypertensive and non-diabetic patients had type 1 lesions (p<0.001). Similarly, patients with LV dysfunction had type 4 lesion compared to the patients without LV dysfunction who had type 1 lesions (p<0.001) Conclusions: Patients with permanent pacemakers having coronary artery disease are more likely to have specific coronary angiographic findings. Therefore, the site of lesions and not the severity or extent of atherosclerosis is responsible for the conduction disturbances.