{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T05:04:41Z","timestamp":1777007081321,"version":"3.51.4"},"reference-count":17,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2014,5,4]],"date-time":"2014-05-04T00:00:00Z","timestamp":1399161600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2014,9]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Patients with a pacing indication and first\u2010degree atrioventricular (AV)\u2010block pose a clinical challenge. The prognostic impact of first\u2010degree AV\u2010block in patients with sinus node dysfunction and the impact of pacing in this setting are not known.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In the Mode Selection Trial (MOST), 2,010 patients with sinus node dysfunction were randomized to either dual\u2010chamber (DDD\u2010R) or ventricular (VVI\u2010R) pacing and followed for a median of 33 months. We report on clinical outcomes in patients with first\u2010degree AV\u2010block (PR interval &gt; 200 ms) compared with patients who had a normal PR interval at baseline.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients with first\u2010degree AV\u2010block (n = 378) were older (median [Q1, Q3]; 76 [70, 82] years vs 73 [66, 79] years, P&lt; 0.0001), more often male (57% vs 49%, P = 0.0049), and had more comorbidity, such as hypertension (66% vs 60%, P = 0.034) and heart failure (24% vs 17%, P = 0.0050) than patients with normal AV\u2010conduction (n = 1,159). In multivariable analyses, patients with first\u2010degree AV\u2010block were at greater risk of death, stroke, or heart failure hospitalization (hazard ratio [HR] 1.31, 95% confidence interval [CI] 1.06\u20131.61, P = 0.013). A trend towards a higher incidence of atrial fibrillation was seen (HR 1.24, 95% CI 0.98\u20131.55, P = 0.069). No significant interactions between pacing arm and prolonged versus normal PR were found for any endpoint, and hazard ratios were consistent across subgroups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>First\u2010degree AV\u2010block is associated with more advanced disease but is still an independent predictor of poor clinical outcome. Neither DDD\u2010R nor VVI\u2010R pacing, as employed in MOST, eliminate the negative effects associated with first\u2010degree AV\u2010block.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pace.12404","type":"journal-article","created":{"date-parts":[[2014,5,5]],"date-time":"2014-05-05T03:47:17Z","timestamp":1399261637000},"page":"1111-1119","source":"Crossref","is-referenced-by-count":12,"title":["Adverse Effects of First\u2010Degree AV\u2010Block in Patients with Sinus Node Dysfunction: Data from the Mode Selection Trial"],"prefix":"10.1111","volume":"37","author":[{"given":"FREDRIK","family":"HOLMQVIST","sequence":"first","affiliation":[{"name":"Clinical Cardiac Electrophysiology, Duke University Medical Center  Durham North Carolina"},{"name":"Duke Clinical Research Institute Duke University Medical Center  Durham North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"ANNE S.","family":"HELLKAMP","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute Duke University Medical Center  Durham North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"KERRY L.","family":"LEE","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute Duke University Medical Center  Durham North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"GERVASIO A.","family":"LAMAS","sequence":"additional","affiliation":[{"name":"Division of Cardiology Columbia University at Mount Sinai Medical Center  Miami Beach Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"JAMES P.","family":"DAUBERT","sequence":"additional","affiliation":[{"name":"Clinical Cardiac Electrophysiology, Duke University Medical Center  Durham North Carolina"},{"name":"Duke Clinical Research Institute Duke University Medical Center  Durham North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,5,4]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198611063151902"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.10.3.384"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.888"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60443-8"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2010.05.038"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eur365"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.288.24.3115"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.2008.01106.x"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2011.07.038"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa013040"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.59.1.40"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehr139"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/eht176"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehr022"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000072769.17295.B1"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.06.006"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2005.05.015"}],"container-title":["Pacing and Clinical Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fpace.12404","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pace.12404","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T02:06:58Z","timestamp":1696471618000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/pace.12404"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,5,4]]},"references-count":17,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2014,9]]}},"alternative-id":["10.1111\/pace.12404"],"URL":"https:\/\/doi.org\/10.1111\/pace.12404","archive":["Portico"],"relation":{},"ISSN":["0147-8389","1540-8159"],"issn-type":[{"value":"0147-8389","type":"print"},{"value":"1540-8159","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,5,4]]}}}