The Relationship between Plasma NT-proBNP Level and Pacing Mode in the Patient with Implanted Permanent Pacemaker
Charn Sriratanasathavorn MD*, Satchana Pumprueg MD**, Warangkna Boonyapisit MD**, Burin Kaosa-ad BEd*, Charuwan Kangkagate MS*
Affiliation : * Her Majesty Cardiac Center, Siriraj Hospital, Mahidol University Bangkok, Thailand ** Division of Cardiology, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
Background and
Objective : Plasma BNP is current one of the prognostic markers for cardiovascular disease including
congestive heart failure. The objective of the present study was to evaluate the level of plasma NT-proBNP in patients who
have had permanent pacemaker implantation.
Material and Method: The clinical characteristics and the plasma NT-proBNP level were recorded and obtained from 284
patients with implanted permanent pacemaker followed-up at the Pacemaker Clinic, Siriraj Hospital. The factors associated
with abnormal NT-proBNP level were analyzed.
Results : Among 284 patients who participated in the present study, 140 patients had NT-proBNP in normal range (level of
< 300 pg/ml). 68 patients had NT-proBNP level between 300 to 900 pg/m/ and 76 patients had NT-proBNP level > 900 pg/ml.
There were significant correlations between log NT-proBNP with patient’s age, left ventricular ejection fraction and serum
creatinine level with age and serum creatinine showing positive correlation and left ventricular ejection fraction having a
negative correlation. From multiple regression analysis, three factors were associated with high NT-proBNP level: older age,
serum creatinine level and ventricular based pacing. The patients with ventricular based pacing mode had higher NT-
proBNP level than patients with atrial based pacing mode even after being adjusted for age and serum creatinine adjusted
Conclusion : In the patient with permanent pacemaker, three factors are associated with high NT-proBNP level. These are
older age, serum creatinine level, and ventricular based pacemaker.
Keywords : Brain natriuretic peptide, Pacemaker, NT-ProBNP, Ventricular-based pacing
