Cognitive function disorders in patients with implantable cardiac pacemaker

Introduction: Pacemaker (PM) is indicated in symp-tomatic patients with sick sinus node syndrome or AV conduction disorder which are diagnosticated by EKG. It has been observed that subjects with bradyarrhyth-mias develop varying degrees of cognitive decline, se-condary to low cerebral flow. However, literature issues related to cognitive function and the presence of car-diac pacemaker are are limited and inconclusive, often contradictory.
Objective: The purpose of this study is to evaluate cog-nitive status in pacemaker patients.
Methods: T he study is observational on 39 subjects divided into 2 groups: the pacemaker group (20 pati-ents) and the control group (19 patients with associa-ted cardiovascular pathology without intracardiac de-vices). Cognitive evaluation was achieved by applying the MMSE and the Clock Test to improve sensitivity in detecting altered cognitive functions related to vi-sual-space integration. Data collection and statistical analysis were performed using the Excel (descriptive statistics) and SPSS 22 (for analytical statistics with the Student (t) test, and the Spearman correlation).
Results: The mean age was 67.5 years for the control group, 68.1 years for the PM group, 47% were women for the control group and 55% women for the PM group. The distribution of the patients according to the pacemaker mode was: 55% VVI mode, 45% DDD mode. No differences were found by applying cogniti-ve scores between subjects with hypertension, diabetes mellitus, or aFib, or related to the type of pacemaker and cognitive dysfunction. There were no differences in language function, temporal-spatial orientation, and function execution between the two groups. An inver-sely weak correlation was observed between age and vi-sual function (r=-0.42). The scores on visuospace func-tion were lower in the PM group (4.5) compared to the control group (4), but without statistical significance (p 0 12). It was observed that pacemaker subjects had sta-tistically significant differences in short-term memory impairment (p<0.00044) and attention deficits with calculation difficulties (p<0.004) compared with the control group.
Conclusions: In conclusion, the study demonstrates that subjects with pacemaker are more likely to deve-lop cognitive dysfunctions such as impaired attention, calculation disorder, and worsening short-term memo-ry compared with subjects with other cardiovascular diseases than bradyarrhythmias. Thus, the assessment of cognitive status in patients with pacemaker becomes important. Lack of diagnosis and early treatment has a negative impact on therapeutic compliance, quality of life, and survival. Consider limitations of the study the number of subjects, lack of data on the percentage of pacing, lack of cognitive pre-implant assessment.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)
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