Table 1
Characteristics of the overall population.
| CLINICAL CHARACTERISTICS | TOTAL (N = 5259) |
|---|---|
| Demographics | |
| Age, Mean ± SD | 69.1 ± 14.8 |
| Sex (Male) | 3,288/5,259 (62.5%) |
| BMI (kg/m²), Mean ± SD | 26.9 ± 5.1 |
| From a ‘young country’* | 1,978/5,259 (37.6%) |
| Device and implant characteristics | |
| Pacemaker | 4,353/5,229 (83.2%) |
| Other devices (ICD/CRT)** | 876/5,229 (16.8%) |
| Single or dual chamber | |
| Single-chamber | 772/4,281 (18.0%) |
| Dual-chamber | 3,509/4,281 (82.0%) |
| Implant setting | |
| Operating room | 804/3,348 (24.0%) |
| EP/cardiac catheter lab | 2544/3,348 (76.0%) |
| Medical history | |
| Hypertension | 3,278/5,250 (62.4%) |
| Diabetes mellitus | 1,505/5,158 (29.2%) |
| Dyslipidemia | 1,779/5,231 (34.0%) |
| Coronary artery disease | 1,380/5,218 (26.4%) |
| Prior myocardial infarction | 702/5,234 (13.4%) |
| Prior CABG | 427/5,257 (8.1%) |
| Atrial fibrillation | 1,025/5,243 (19.5%) |
| Smoking status | |
| Never smoked | 3,318/5,119 (64.8%) |
| Previous smoker | 424/5,119 (8.3%) |
| Current smoker | 1,377/5,119 (26.9%) |
| Blood pressure | |
| Systolic blood pressure, Mean ± SD | 136.1 ± 23.4 |
| Diastolic blood pressure, Mean ± SD | 72.8 ± 12.9 |
| NYHA classification (categorical) | |
| I | 509/5,123 (9.9%) |
| II | 1,090/5,123 (21.3%) |
| III | 704/5,123 (13.7%) |
| IV | 101/5,123 (2.0%) |
| LVEF (%), Mean ± SD | 52.0 ± 16.0 |
| CHADS2 (categorical) | |
| 0 | 805/5,126 (15.7%) |
| 1 | 1,435/5,126 (28.0%) |
| 2 | 1,701/5,126 (33.2%) |
| 3 | 825/5,126 (16.1%) |
| ≥4 | 360/5,126 (7.0%) |
[i] AVB: Atrioventricular block. SD: Standard deviation. BMI: Body mass index. CABG: Coronary artery bypass grafting. NYHA: New York Heart Association functional classification. LVEF: Left Ventricular Ejection Fraction.
*‘young country’ was defined as countries with a median population age of ≤30 (PANORAMA 1) or ≤35 (PANORAMA 2), based on data from the United Nations’ data-portal.
**Other devices refer to: Implantable Cardioverter Defibrillator, Cardiac Resynchronization Therapy Pacemaker, and Cardiac Resynchronization Therapy Defibrillator.
Table 2
Comorbidities and risk factors of AVB in the Middle East compared to the rest of the world.
| CLINICAL CHARACTERISTICS | MIDDLE EAST(N = 640) | REST OF THE WORLD(N = 4619) | P VALUE |
|---|---|---|---|
| Demographics | |||
| Age, Mean ± SD | 62.9 ± 17.8 | 70.0 ± 14.1 | <0.001 |
| Sex (Male) | 373/640 (58.3%) | 2,915/4,619 (63.1%) | 0.018 |
| BMI (kg/m²), Mean ± SD | 28.6 ± 6.3 | 26.6 ± 4.8 | <0.001 |
| From a “young country”* | 640/640 (100.0%) | 1,338/4,619(29.0%) | <0.001 |
| Device and implant characteristics | <0.001 | ||
| Pacemaker | 489/639 (76.5%) | 3,864/4,590 (84.2%) | |
| Other devices (ICD/CRT)** | 150/639 (23.5%) | 726/4,590 (15.8%) | |
| Single or dual chamber | <0.001 | ||
| Single-chamber | 172/549 (31.3%) | 600/3,732 (16.1%) | |
| Dual-chamber | 377/549 (68.7%) | 3,132/3,732 (83.9%) | |
| Implant setting | <0.001 | ||
| Operating room | 14/530 (2.6%) | 790/2,818 (28.0%) | |
| EP/cardiac catheter lab | 516/530 (97.4%) | 2,028/2,818 (72.0%) | |
| Medical history | |||
| Hypertension | 395/639 (61.8%) | 2,883/4,611 (62.5%) | 0.729 |
| Diabetes mellitus | 300/639 (46.9%) | 1,205/4,519 (26.7%) | <0.001 |
| Dyslipidemia | 276/639 (43.2%) | 1,503/4,592 (32.7%) | <0.001 |
| Coronary artery disease | 198/638 (31.0%) | 1,182/4,580 (25.8%) | 0.005 |
| Prior myocardial infarction | 80/636 (12.6%) | 622/4,598 (13.5%) | 0.510 |
| Prior CABG | 63/640 (9.8%) | 364/4,617 (7.9%) | 0.089 |
| Atrial fibrillation | 65/640 (10.2%) | 960/4,603 (20.9%) | <0.001 |
| Smoking status | <0.001 | ||
| Never smoked | 452/638 (70.8%) | 2,866/4,481 (64.0%) | |
| Previous smoker | 56/638 (8.8%) | 368/4,481 (8.2%) | |
| Current smoker | 130/638 (20.4%) | 1,247/4,481 (27.8%) | |
| Blood pressure | |||
| Systolic blood pressure, Mean ± SD | 129.9 ± 22.5 | 136.5 ± 23.4 | 0.007 |
| Diastolic blood pressure, Mean ± SD | 66.4 ± 13.1 | 73.2 ± 12.7 | <0.001 |
| NYHA classification (categorical) | <0.001 | ||
| I | 55/639 (8.6%) | 454/4,484 (10.1%) | |
| II | 86/639 (13.5%) | 1,004/4,484(22.4%) | |
| III | 64/639 (10.0%) | 640/4,484 (14.3%) | |
| IV | 17/639 (2.7%) | 84/4,484(1.9%) | |
| LVEF (%), Mean ± SD | 47.5 ± 16.1 | 52.8 ± 15.8 | <0.001 |
| CHADS2 (categorical) | <0.001 | ||
| 0 | 133/638 (20.8%) | 672/4,488 (15.0%) | |
| 1 | 140/638 (21.9%) | 1,295/4,488 (28.9%) | |
| 2 | 222/638 (34.8%) | 1,479/4,488 (33.0%) | |
| 3 | 112/638 (17.6%) | 713/4,488 (15.9%) | |
| ≥4 | 31/638 (4.9%) | 329/4,488 (7.3%) |
[i] AVB: Atrioventricular block. SD: Standard deviation. BMI: Body mass index. CABG: Coronary artery bypass grafting. NYHA: New York Heart Association functional classification. LVEF: Left Ventricular Ejection Fraction.
*‘young country’ was defined as countries with a median population age of ≤30 (PANORAMA 1) or ≤35 (PANORAMA 2), based on data from the United Nations’ data-portal.
**Other devices refer to: Implantable Cardioverter Defibrillator, Cardiac Resynchronization Therapy Pacemaker, and Cardiac Resynchronization Therapy Defibrillator.
Table 3
Multivariate logistic regression for age of presentation less than 50 years.
| VARIABLE | OR(95% CI) | P VALUE |
|---|---|---|
| Middle East | 1.54(1.19–2.00) | 0.001 |
| Young Country | 2.15(1.74–2.67) | <0.001 |
[i] CI: Confidence interval. OR: Odds ratio.
Table 4
Multivariate linear regression for mean age at presentation.
| VARIABLE | MEAN CHANGE(95% CI) | P VALUE |
|---|---|---|
| Middle East | –3.1(–4.5––1.8) | <0.001 |
| Young Country | –5.6(–6.5––4.6) | <0.001 |
[i] CI: Confidence interval.
Figure 1
An illustration highlighting the effect of the average age of populations on lowering the average age at presentation, even if the age-adjusted prevalence is similar between the two populations. Despite a hypothetically similar prevalence of AVB in each age group, the mean age at presentation with AVB is 10 years younger due to a 10-year difference in the average age overall. AVB: atrioventricular block.