Clinical predictors of health-related quality of life after pacemaker implantation

Background: Health-related quality of life (HRQL) is increasingly accepted as an outcome measure when considering the effectiveness of therapeutic interventions. Little is known about the HRQL of patients with different clinical circumstances before and after pacemaker implantation (PMI). The purpose of this study was to investigate the influence of clinical symptoms and ECG diagnoses as predictors of improved HRQL in patients referred for PMI. Methods: Sixty eight patients with different indications for PMI completed the MacNew Heart Disease Health-related Quality of Life Questionnaire (MacNew) and the Short Form-36 Health Survey (SF-36) before and one, three and six months after PMI. Symptoms, ECG indications and pacing mode were collected using the European Pacemaker Patient Identification Card codes. Results: Within the first month after PMI overall MacNew but not SF-36 scores improved significantly and was maintained during the entire 6 month follow up period. Improvement in HRQL as measured with the MacNew was rather related to baseline symptoms and ECG diagnosis than to the pacing mode. Conclusion: The important finding of this study is that improved HRQL seen after PMI appears to be largely driven by baseline symptoms and the ECG diagnoses rather than the pacing mode of the device.