Mobitz type I 2nd degree atrioventricular (Wenckebach) block and cardiovascular death using 978,901 12 lead ECGs recordings

Abstract Background Mobitz type I 2nd degree atrioventricular (AV) block (Wenckebach) is usually considered benign. Guidelines recommend permanent cardiac pacing for patients with II second AV (Mobitz II), but Wenckebach, only indicated if the causes symptoms or conductions delay occurs below bundle of His. However, these guidelines are based on evidence modest quality and a consensus amongst experts (1). Purpose This study aims to investigate Wenckebach really benign by comparing risk cardiovascular death normal ECGs. Methods retrospective cohort included 978,901 ECGs obtained from general practitioners in Denmark 01/02/2001 31/10/2014. Index date was day ECG recording were followed until end follow up at December 2019. The association between analyzed using: 1) multivariate Cox models adjusted age comorbidities, 2) cause-specific 3) cumulative hazard function plots, compared matched controls. Information about pacemaker, indications, retrieved Danish nationwide registries. Results From recordings, we found 262 131 II, 229,056 In median 76, 80, 50 years, 76%, 63%, 41% male, 25%, 16%, 3% had diabetes, 35%, 30%, 8% hypertension, respectively. During mean follow-up 11.2 occurred total 11,301 patients: 77 (29%) 40 (31%) 11,184 (5%) 520 controls model, associated (HR: 2.14 [95% CI: 1.46–3.13], P<0.001). Furthermore, analysis non-cardiovascular pacemaker as competing risk, still 2.27 1.37–3.75], P=0.001). results showed that 43% received time being 252 days. vast majority who higher than indication implantation. Conclusion routine significant rate Funding Acknowledgement Type funding sources: Foundation. Main source(s): Heart Association