{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:51:07Z","timestamp":1787838667788,"version":"build-2784847793"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Risk factors for needing a pacemaker have not been well studied. The goal of this study was to evaluate predictors, complications, trends, and mortality rates of pacemakers in adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We utilized the International Classification of Diseases, Tenth Revision, and Clinical Modification coding for this study. We evaluated clinical predictors of pacemaker insertions, their complications, and mortality using the Nationwide Inpatient Sample database for the years 2016\u20132020 in adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 647,435 patients had a pacemaker insertion at an average age of 76 years old (\u00b111.48 years). Significant independent clinical predictors for pacer insertion were non-ST-elevation myocardial infarction: 4.3% versus 2.4%, odds ratio (OR), 1.85; 95% confidence interval (CI), 1.80\u20131.91;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001, hypertension: 84.40% versus 55.95%, OR, 4.26; 95% CI, 4.19\u20134.34;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001, hyperlipidemia: 59.59% versus 2.85%, OR, 3.01; 95% CI, 2.97\u20133.05;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001, atrial fibrillation\/flutter: 45.89% versus 15.35%, OR, 4.68 95% CI, 4.62\u20134.74;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001, diabetes: 35.76% versus 27.20%, OR, 1.49; 95% CI, 1.47\u20131.51;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001, chronic kidney disease: 30.00% versus 17.70%, OR, 1.99; 95% CI, 1.97\u20132.02;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001, smoking: 29.81% versus 23.10%, OR, 1.41; 95% CI, 1.31\u20131.43;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001, chronic obstructive pulmonary disease: 17.63% versus 16.17%, OR, 1.11; 95% CI, 1.09\u20131.13;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001, valvular heart disease: 17.19% versus 3.76%, OR, 5.31; 95% CI, 5.21\u20135.41;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001, systolic heart failure: 12.94% versus 6.99%, OR, 1.98; 95% CI, 1.94\u20132.02;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001, prior percutaneous intervention: 11.70% versus 5.45%, OR, 2.30; 95% CI, 2.26\u20132.34;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001, obesity: 10.05% versus 8.57%, 1.19; 95% CI, 1.17\u20131.22;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001, history of coronary artery bypass grafting: 10.05% versus 4.32%, OR, 2.48; 95% CI, 2.43\u20132.52;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001, STEMI: 1.45% versus 2.66%, 1.45% OR, 1.86; 95% CI, 1.79\u20131.93;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001, history of cardiomyopathy: 0.74% versus 0.39%, OR, 1.90; 95% CI, 1.78\u20132.03;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001, and endocarditis: 0.15% versus 0.09%, OR, 1.77; 95% CI, 1.53\u20132.04;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001. Pacemaker complication rates were around 2% with a mortality of 1.44%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>We found many predictors for the need for pacemaker insertion. Mortality and complications have remained low over recent years with higher prevalence in males and Caucasians.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/heartviews.heartviews_157_24","type":"journal-article","created":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T18:00:10Z","timestamp":1759341610000},"page":"102-107","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Independent Predictors of Receiving Pacemaker with Trends of Complications and Mortality in the United States with Higher Prevalence in Male and Caucasians"],"prefix":"10.4103","volume":"26","author":[{"given":"Mohammad Reza","family":"Movahed","sequence":"first","affiliation":[{"name":"Department of Medicine, University of Arizona College of Medicine, Tucson, Arizona, USA"},{"name":"Department of Medicine, University of Arizona College of Medicine, Phoenix, Arizona, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nandini","family":"Sodhi","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Arizona College of Medicine, Tucson, Arizona, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehrtash","family":"Hashemzadeh","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Arizona College of Medicine, Phoenix, Arizona, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,10,1]]},"reference":[{"key":"R1-20251007","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1016\/j.ijcard.2013.08.093","article-title":"A short history on pacemakers","volume":"169","author":"Ward","year":"2013","journal-title":"Int J Cardiol"},{"key":"R2-20251007","first-page":"1563","article-title":"Indications and recommendations for pacemaker therapy","volume":"71","author":"Gregoratos","year":"2005","journal-title":"Am Fam Physician"},{"key":"R3-20251007","first-page":"42","article-title":"The epidemiology of pacemaker implantation in the United States","volume":"110","author":"Silverman","year":"1995","journal-title":"Public Health Rep"},{"key":"R4-20251007","first-page":"1","article-title":"Hypertension prevalence and control among adults: United States, 2015-2016","volume":"289","author":"Fryar","year":"2017","journal-title":"NCHS Data Brief."},{"key":"R5-20251007","first-page":"324","article-title":"National and state estimates of COPD morbidity and mortality \u2013 United states, 2014-2015","volume":"5","author":"Sullivan","year":"2018","journal-title":"Chronic Obstr Pulm Dis"},{"key":"R6-20251007","doi-asserted-by":"crossref","first-page":"473","DOI":"10.7326\/M16-0273","article-title":"Trends in prevalence of chronic kidney disease in the United States","volume":"165","author":"Murphy","year":"2016","journal-title":"Ann Intern Med"},{"key":"R7-20251007","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1016\/j.resinv.2019.01.003","article-title":"Obesity is strongly and independently associated with a higher prevalence of pulmonary embolism","volume":"57","author":"Movahed","year":"2019","journal-title":"Respir Investig"},{"key":"R8-20251007","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1016\/j.jtcvs.2011.07.004","article-title":"Tricuspid valve surgery: The past 10 years from the Nationwide Inpatient Sample (NIS) database","volume":"143","author":"Vassileva","year":"2012","journal-title":"J Thorac Cardiovasc Surg"},{"key":"R9-20251007","first-page":"1","article-title":"Changes in the leading cause of death: Recent patterns in heart disease and cancer mortality","volume":"254","author":"Heron","year":"2016","journal-title":"NCHS Data Brief."},{"key":"R10-20251007","doi-asserted-by":"crossref","first-page":"1448","DOI":"10.1093\/eurheartj\/ehu028","article-title":"Early management of atrial fibrillation to prevent cardiovascular complications","volume":"35","author":"Nattel","year":"2014","journal-title":"Eur Heart J"},{"key":"R11-20251007","doi-asserted-by":"crossref","first-page":"1540","DOI":"10.1016\/j.jacc.2012.07.017","article-title":"Trends in permanent pacemaker implantation in the United States from 1993 to 2009: Increasing complexity of patients and procedures","volume":"60","author":"Greenspon","year":"2012","journal-title":"J Am Coll Cardiol"},{"key":"R12-20251007","doi-asserted-by":"crossref","first-page":"e000177","DOI":"10.1136\/openhrt-2014-000177","article-title":"Trends in the incidence and prevalence of cardiac pacemaker insertions in an ageing population","volume":"1","author":"Bradshaw","year":"2014","journal-title":"Open Heart"},{"key":"R13-20251007","doi-asserted-by":"crossref","first-page":"1073","DOI":"10.1016\/0002-8703(94)90090-6","article-title":"Complications of pacemaker-defibrillator devices: Diagnosis and management","volume":"127","author":"Pfeiffer","year":"1994","journal-title":"Am Heart J"},{"key":"R14-20251007","doi-asserted-by":"crossref","first-page":"884","DOI":"10.1093\/europace\/eum113","article-title":"Incidence and predictors of in-hospital events after first implantation of pacemakers","volume":"9","author":"van Eck","year":"2007","journal-title":"Europace"},{"key":"R15-20251007","doi-asserted-by":"crossref","first-page":"1289","DOI":"10.1016\/j.hrthm.2022.03.1226","article-title":"Clinical outcomes and predictors of complications in patients undergoing leadless pacemaker implantation","volume":"19","author":"Haddadin","year":"2022","journal-title":"Heart Rhythm"},{"key":"R16-20251007","doi-asserted-by":"crossref","first-page":"810","DOI":"10.1016\/j.amjcard.2010.04.043","article-title":"50th Anniversary of the first successful permanent pacemaker implantation in the United States: Historical review and future directions","volume":"106","author":"Beck","year":"2010","journal-title":"Am J Cardiol"},{"key":"R17-20251007","first-page":"249","article-title":"Leadless pacemakers: A contemporary review","volume":"15","author":"Bhatia","year":"2018","journal-title":"J Geriatr Cardiol"},{"key":"R18-20251007","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1007\/s10840-011-9618-5","article-title":"Pacemaker implantation in the extreme elderly","volume":"33","author":"Stevenson","year":"2012","journal-title":"J Interv Card Electrophysiol"},{"key":"R19-20251007","doi-asserted-by":"crossref","first-page":"1186","DOI":"10.1093\/eurheartj\/eht511","article-title":"Complications after cardiac implantable electronic device implantations: An analysis of a complete, nationwide cohort in Denmark","volume":"35","author":"Kirkfeldt","year":"2014","journal-title":"Eur Heart J"},{"key":"R20-20251007","doi-asserted-by":"crossref","first-page":"1562","DOI":"10.1111\/pace.14314","article-title":"Predictors of outcomes in hospitalized patients undergoing pacemaker insertion: Analysis from the national inpatient database (2016-2017)","volume":"44","author":"Kichloo","year":"2021","journal-title":"Pacing Clin Electrophysiol"},{"key":"R21-20251007","doi-asserted-by":"crossref","first-page":"euad269","DOI":"10.1093\/europace\/euad269","article-title":"Comparison of in-hospital outcomes and complications of leadless pacemaker and traditional transvenous pacemaker implantation","volume":"25","author":"Alhuarrat","year":"2023","journal-title":"Europace"},{"key":"R22-20251007","doi-asserted-by":"crossref","first-page":"40","DOI":"10.4103\/0972-4958.158933","article-title":"Clinical profiles and outcomes of patients undergoing pacemaker implantation","volume":"29","author":"Kanse,","year":"2015","journal-title":"Journal of Medical Society"}],"container-title":["Heart Views"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/heartviews.heartviews_157_24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:38:05Z","timestamp":1786649885000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/heartviews.heartviews_157_24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4]]},"references-count":22,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/heartviews.heartviews_157_24","relation":{},"ISSN":["1995-705X","0976-5123"],"issn-type":[{"value":"1995-705X","type":"print"},{"value":"0976-5123","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4]]},"assertion":[{"value":"2024-12-12","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-19","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}