{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T23:47:42Z","timestamp":1780098462357,"version":"3.54.0"},"reference-count":20,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,2,18]],"date-time":"2021-02-18T00:00:00Z","timestamp":1613606400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Mitral valve surgery has developed into a strong subspecialty of cardiac surgery with operative techniques and outcomes constantly improving. The development of bradyarrhythmias after mitral valve surgery is not completely understood.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We investigated a cohort of 797 patients requiring mitral valve surgery with and without concomitant procedures. Incidences and predictors of pacemaker requirement as well as survival were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the complete follow\u2010up period (median follow\u2010up time: 6.09 years [95% confidence interval [CI]: 5.94\u20136.22 years, maximum 8.77 years) 80 patients (10% of the complete cohort) required pacemaker implantation for bradyarrhythmia. The cumulative rate of pacemaker implantation was 6.4% at 50 days (48 patients) with most (54.2%) requiring pacing for atrioventricular block. Mitral valve replacement (odds ratio [OR]: 1.905; 95% CI: 1.206\u20133.536; <jats:italic>p<\/jats:italic>\u2009=\u2009.041) and tricuspid ring annuloplasty (OR: 2.348; 95% CI: 1.165\u20134.730, <jats:italic>p<\/jats:italic>\u2009=\u2009.017) were identified as operative risk factors of pacemaker requirement after mitral valve surgery. Insulin\u2010dependent diabetes mellitus was also identified as a predictor of pacemaker requirement (OR: 4.665; 95% CI: 1.975\u201311.02; <jats:italic>p<\/jats:italic>\u2009=\u2009.001). There was no difference in survival in the paced and unpaced groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>After mitral valve surgery, a relevant subgroup of patients requires pacemaker implantation\u2014most for atrioventricular block. We identified mitral valve replacement and tricuspid ring annuloplasty as significant operative risk factors and insulin\u2010dependent diabetes mellitus as a demographic risk factor. While anatomic relationships help explain the operative risk factors the role of diabetes mellitus is not completely understood.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.14932","type":"journal-article","created":{"date-parts":[[2021,2,10]],"date-time":"2021-02-10T16:42:46Z","timestamp":1612975366000},"page":"1103-1110","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Tricuspid valve annuloplasty and mitral valve replacement are associated with bradyarrhythmia after mitral valve surgery"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3820-1655","authenticated-orcid":false,"given":"Florian E.\u00a0M.","family":"Herrmann","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery Ludwig Maximilian University Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne\u2010Sophie","family":"Schleith","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery Ludwig Maximilian University Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Graf","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery Ludwig Maximilian University Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Sadoni","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery Ludwig Maximilian University Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Hagl","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery Ludwig Maximilian University Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Bagaev","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery Ludwig Maximilian University Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerd","family":"Juchem","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery Ludwig Maximilian University Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,2,18]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2008.07.028"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehq222"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehx391"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.116.023340"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2017.07.089"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2016.11.029"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.02.062"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-150-9-200905050-00006"},{"key":"e_1_2_6_10_1","volume-title":"R: A Language and Environment for Statistical Computing","author":"R Core Team","year":"2018"},{"key":"e_1_2_6_11_1","unstructured":"TherneauT.\u00a0A package for survival analysis in S version 2.38; 2015.https:\/\/CRAN.Rproject.org\/package=survival. 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