{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T17:05:36Z","timestamp":1784739936832,"version":"3.55.0"},"reference-count":29,"publisher":"Sociedade Brasileira de Cardiologia","issue":"5","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq. Bras. Cardiol."],"abstract":"<jats:p>Resumo  Fundamento  O implante de marca-passo permanente \u00e9 um tratamento estabelecido tanto para a s\u00edndrome do n\u00f3 sinusal (SNS) quanto para o bloqueio atrioventricular (BAV), por\u00e9m existem poucos dados comparando os resultados cl\u00ednicos a longo prazo e os padr\u00f5es de remodelamento card\u00edaco entre essas distintas etiologias bradiarr\u00edtmicas.  Objetivos  Comparar os resultados cl\u00ednicos e as altera\u00e7\u00f5es estruturais card\u00edacas em tr\u00eas anos entre pacientes com SNS e BAV ap\u00f3s implante de marca-passo permanente.  M\u00e9todos  Este estudo observacional retrospectivo incluiu 192 pacientes adultos (65 com SNS, 127 com BAV) submetidos a implante de marca-passo entre janeiro de 2018 e dezembro de 2020. Dados demogr\u00e1ficos, par\u00e2metros ecocardiogr\u00e1ficos, dados registrados pelo marca-passo e desfechos cl\u00ednicos foram avaliados no in\u00edcio do estudo, ap\u00f3s um m\u00eas, seis meses, um ano e tr\u00eas anos. Os desfechos prim\u00e1rios inclu\u00edram altera\u00e7\u00f5es na estrutura e fun\u00e7\u00e3o card\u00edacas, melhora dos sintomas, fibrila\u00e7\u00e3o atrial de in\u00edcio recente, reinterna\u00e7\u00e3o e mortalidade por todas as causas.  Resultados  Ambos os grupos demonstraram decl\u00ednios significativos na fra\u00e7\u00e3o de eje\u00e7\u00e3o do ventr\u00edculo esquerdo ao longo de tr\u00eas anos (SNS: 57,2\u00b16,0% para 54,3\u00b18,3%, p&lt;0,001; BAV: 55,5\u00b17,0% para 53,0\u00b16,8%, p&lt;0,001). Apesar da progress\u00e3o semelhante da disfun\u00e7\u00e3o ventricular, padr\u00f5es distintos de remodelamento emergiram: os pacientes com SNS apresentaram aumentos significativos no di\u00e2metro do \u00e1trio esquerdo (31,3 para 38,8 mm, p=0,040), no di\u00e2metro diast\u00f3lico final do ventr\u00edculo esquerdo (45,2 para 51,0 mm, p&lt;0,001) e na preval\u00eancia de regurgita\u00e7\u00e3o mitral (26,2% para 64,6%), enquanto os pacientes com BAV mantiveram dimens\u00f5es ventriculares est\u00e1veis apesar da alta carga de estimula\u00e7\u00e3o ventricular (&gt;90%). A melhora dos sintomas foi compar\u00e1vel (SNS: 85,6% vs. BAV: 83,5%, p=0,84), assim como o surgimento de fibrila\u00e7\u00e3o atrial (41,5% vs. 37,0%, p=0,54), a reinterna\u00e7\u00e3o (50,8% vs. 58,3%, p=0,38) e a mortalidade por todas as causas (13,8% vs. 11,8%, p=0,69). Os preditores de mortalidade diferiram: gravidade da regurgita\u00e7\u00e3o mitral em pacientes com SNS versus doen\u00e7a arterial coronariana, terapia com betabloqueadores e volume do \u00e1trio esquerdo em pacientes com BAV.  Conclus\u00f5es  Apesar dos benef\u00edcios sintom\u00e1ticos e resultados cl\u00ednicos semelhantes, pacientes com SNS e BAV demonstram padr\u00f5es distintos de remodelamento card\u00edaco e diferentes preditores de mortalidade, o que refor\u00e7a a necessidade de estrat\u00e9gias de acompanhamento espec\u00edficas para cada etiologia em pacientes com marca-passo.<\/jats:p>","DOI":"10.36660\/abc.20250751","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T16:55:28Z","timestamp":1784739328000},"source":"Crossref","is-referenced-by-count":0,"title":["Resultados Cl\u00ednicos ap\u00f3s Implante de Marca-Passo: Um Estudo Comparativo de 3 Anos entre S\u00edndrome do N\u00f3 Sinusal e Bloqueio Atrioventricular"],"prefix":"10.36660","volume":"123","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6414-3743","authenticated-orcid":false,"given":"Fuat","family":"Polat","sequence":"first","affiliation":[{"name":"Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Education Research Hospital,  Turquia; Health Science University,  Turquia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2356-1460","authenticated-orcid":false,"given":"Ha\u015fim","family":"T\u00fcner","sequence":"additional","affiliation":[{"name":"Istanbul Arel University Memorial Bahcelievler Hospital,  Turquia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4731-4061","authenticated-orcid":false,"given":"Veysi","family":"Can","sequence":"additional","affiliation":[{"name":"Van Health Sciences University Training and Research Hospital,  Turquia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6866-0625","authenticated-orcid":false,"given":"Sait","family":"Terzi","sequence":"additional","affiliation":[{"name":"Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Education Research Hospital,  Turquia; Health Science University,  Turquia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"22636","published-online":{"date-parts":[[2026]]},"reference":[{"issue":"7","key":"ref1","doi-asserted-by":"crossref","first-page":"932","DOI":"10.1016\/j.jacc.2018.10.043","article-title":"2018 ACC\/AHA\/HRS Guideline on the Evaluation and Management of Patients with Bradycardia and Cardiac Conduction Delay: Executive Summary: A Report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines, and the Heart Rhythm Society","volume":"74","author":"Kusumoto FM","year":"2019","journal-title":"J Am Coll Cardiol"},{"issue":"23","key":"ref2","doi-asserted-by":"crossref","first-page":"2932","DOI":"10.1161\/01.CIR.0000072769.17295.B1","article-title":"Adverse effect of ventricular pacing on heart failure and atrial fibrillation among patients with normal baseline QRS duration in a clinical trial of pacemaker therapy for sinus node dysfunction","volume":"107","author":"Sweeney MO","year":"2003","journal-title":"Circulation"},{"issue":"23","key":"ref3","doi-asserted-by":"crossref","first-page":"2932","DOI":"10.1161\/01.CIR.0000072769.17295.B1","article-title":"Adverse Effect of Ventricular Pacing on Heart Failure and Atrial Fibrillation among Patients with Normal Baseline QRS Duration in a Clinical Trial of Pacemaker Therapy for Sinus Node Dysfunction","volume":"107","author":"Sweeney MO","year":"2003","journal-title":"Circulation"},{"issue":"21","key":"ref4","doi-asserted-by":"crossref","first-page":"1883","DOI":"10.1093\/eurheartj\/ehy037","article-title":"2018 ESC Guidelines for the Diagnosis and Management of Syncope","volume":"39","author":"Brignole M","year":"2018","journal-title":"Eur Heart J"},{"issue":"6","key":"ref5","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.hrthm.2008.04.014","article-title":"ACC\/AHA\/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities","volume":"5","author":"Epstein AE","year":"2008","journal-title":"Heart Rhythm"},{"issue":"9","key":"ref6","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1016\/j.jacc.2009.06.006","article-title":"The Effects of Right Ventricular Apical Pacing on Ventricular Function and Dyssynchrony Implications for Therapy","volume":"54","author":"Tops LF","year":"2009","journal-title":"J Am Coll Cardiol"},{"issue":"19","key":"ref7","doi-asserted-by":"crossref","first-page":"1396","DOI":"10.1093\/eurheartj\/ehs454","article-title":"Cardiac Resynchronization Therapy: State of the Art 2013","volume":"34","author":"Yu CM","year":"2013","journal-title":"Eur Heart J"},{"issue":"5","key":"ref8","first-page":"1005","article-title":"Post-pacemaker implant QRS duration and heart failure admission in patients with sick sinus syndrome and complete atrioventricular block","volume":"6","author":"Cheng YJ","year":"2019","journal-title":"ESC Heart Failure"},{"issue":"7","key":"ref9","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1111\/j.1540-8159.2006.00422.x","article-title":"Reducing Unnecessary Right Ventricular Pacing with the Managed Ventricular Pacing Mode in Patients with Sinus Node Disease and AV Block","volume":"29","author":"Gillis AM","year":"2006","journal-title":"Pacing Clin Electrophysiol"},{"issue":"29","key":"ref10","doi-asserted-by":"crossref","first-page":"2281","DOI":"10.1093\/eurheartj\/eht150","article-title":"2013 ESC Guidelines on Cardiac Pacing and Cardiac Resynchronization Therapy: The Task Force on Cardiac Pacing and Resynchronization Therapy of the European Society of Cardiology (ESC). 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