{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T02:43:23Z","timestamp":1777517003915,"version":"3.51.4"},"reference-count":29,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,11,1]],"date-time":"2023-11-01T00:00:00Z","timestamp":1698796800000},"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":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Permanent pacemaker (PPM) implantation is a well\u2010established treatment for symptomatic sinus node dysfunction (SND). The optimal timing of this intervention is unclear, with atrioventricular blocks often prioritized in resource stressed waiting lists due to mortality concerns.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Mortality data was compared between patients receiving elective outpatient (OP) PPM implantation, and those presenting to hospital for urgent inpatient (IP) management for symptomatic SND. Survival analysis was conducted using Kaplan\u2010Meier plots and compared using the log\u2010rank test. Univariable and multivariable Cox regression, as well as propensity score matching analyses were performed to assess the prognostic effect on 30\u2010day and 1\u2010year all\u2010cause mortality of inpatient implant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 1269 patients identified with isolated SND, 740 (58%) had PPMs implanted on an OP and 529 (42%) on an IP basis. Mortality was significantly worse in patients where management was driven by hospital admission on an urgent basis (Log\u2010Rank \u03c72\u00a0=\u00a021.6, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001) and remained an independent predictor of 1\u2010year all\u2010cause mortality (HR 3.40, 95% CI 1.97\u20135.86, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001) on multivariable analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>SND is predominantly a disease associated with ageing and comorbid populations, where avoidance of deconditioning, hospitalization acquired infections, and polypharmacy is advantageous. Admission avoidance is therefore the preferable strategy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pace.14856","type":"journal-article","created":{"date-parts":[[2023,11,1]],"date-time":"2023-11-01T17:21:03Z","timestamp":1698859263000},"page":"1465-1471","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Hospitalization for permanent pacemaker implantation in the context of isolated sinus node dysfunction is associated with increased mortality compared with an outpatient strategy"],"prefix":"10.1111","volume":"46","author":[{"given":"Alexander","family":"Sharp","sequence":"first","affiliation":[{"name":"Department of Cardiology Norfolk and Norwich University Hospital  Norwich Norfolk UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8353-4806","authenticated-orcid":false,"given":"Gareth","family":"Matthews","sequence":"additional","affiliation":[{"name":"Department of Cardiology Norfolk and Norwich University Hospital  Norwich Norfolk UK"},{"name":"Department of Cardiology Norwich Medical School University of East Anglia  Norwich UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2063-2510","authenticated-orcid":false,"given":"Nikolaos","family":"Papageorgiou","sequence":"additional","affiliation":[{"name":"Department of Cardiology St Bartholomew's Hospital EC1A 7BE  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Till","sequence":"additional","affiliation":[{"name":"Department of Cardiology Norfolk and Norwich University Hospital  Norwich Norfolk UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Raine","sequence":"additional","affiliation":[{"name":"Department of Cardiology Norfolk and Norwich University Hospital  Norwich Norfolk UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ian","family":"Williams","sequence":"additional","affiliation":[{"name":"Department of Cardiology Norfolk and Norwich University Hospital  Norwich Norfolk UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cairistine","family":"Grahame\u2010Clarke","sequence":"additional","affiliation":[{"name":"Department of Cardiology Norfolk and Norwich University Hospital  Norwich Norfolk UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Santosh","family":"Nair","sequence":"additional","affiliation":[{"name":"Department of Cardiology Norfolk and Norwich University Hospital  Norwich Norfolk UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omar","family":"Abdul\u2010Samad","sequence":"additional","affiliation":[{"name":"Department of Cardiology Norfolk and Norwich University Hospital  Norwich Norfolk UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vassilios","family":"Vassiliou","sequence":"additional","affiliation":[{"name":"Department of Cardiology Norfolk and Norwich University Hospital  Norwich Norfolk UK"},{"name":"Department of Cardiology Norwich Medical School University of East Anglia  Norwich UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pankaj","family":"Garg","sequence":"additional","affiliation":[{"name":"Department of Cardiology Norfolk and Norwich University Hospital  Norwich Norfolk UK"},{"name":"Department of Cardiology Norwich Medical School University of East Anglia  Norwich UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei Yao","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Cardiology Norfolk and Norwich University Hospital  Norwich Norfolk UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,11]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab364"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.10.044"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.96.1.260"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1460-9592.2001.00842.x"},{"key":"e_1_2_11_6_1","doi-asserted-by":"crossref","unstructured":"MondHG ProclemerA The 11th world survey of cardiac pacing and implantable cardioverter\u2010defibrillators: calendar Year 2009\u2010A World Society of Arrhythmia's Project: 2009 survey cardiac pacemakers and ICDS. 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