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Background: The possibility of sexual functioning is an important aspect of human life, and sexual disorders have a negative impact on the quality of life and well-being. The aim of the study was to assess the sexuality and occurrence of sexual dysfunction within 6 months after pacemaker implantation., Methods and Results: The study sample was a group of 80 patients with heart rhythm disorders who had been qualified for cardiac pacemaker implantation. The International Index of Erectile Function (IIEF)-15 was completed by all the patients at least 1 day before and 6 months after cardiac pacemaker implantation. The average results of the IIEF for all those who were included before implantation were 41.87 ± 7.57 and were statistically the worst after pacemaker implantation 46.76 ± 6.64; P < .0001. After the implantation of a pacemaker, there was an improvement in all of the subcategories of sexual life for all the men: erectile function P < .0001, orgasmic function P < .0001, sexual desire P < .0001, intercourse satisfaction P < .0001, and overall satisfaction P < .0001., Conclusions: Pacemaker implantation had a positive effect on sexual functioning for all the patients. Pacemaker implantation did not affect sexual desire in the patients who were observed. Erectile dysfunction occurred in most of patients both before and after pacemaker implantation., (© 2020 Wiley Periodicals LLC.)

Background: Permanent right ventricular pacing (RVP) results in cardiac dyssynchrony that may lead to heart failure and may be an indication for the use of cardiac resynchronization therapy (CRT). The study aimed to evaluate predictors of outcomes in patients with pacing-induced cardiomyopathy (PICM) if upgraded to CRT., Methods: One hundred fifteen patients, 75.0 years old (IQR 67.0-80.0), were upgraded to CRT due to the decline in left ventricle ejection fraction (LVEF) caused by the long-term RVP. A retrospective analysis was performed using data from hospital and outpatient clinic records and survival data from the National Health System., Results: The prior percentage of RVP was 100.0% (IQR 97.0-100.0), with a QRS duration of 180.0 ms (IQR 160.0-200.0). LVEF at the time of the upgrade procedure was 27.0% (IQR 21.0-32.75). The mean follow-up was 980 ± 522 days. The primary endpoint, death from any cause, was met by 26 (22%) patients. Age > 82 years (HR 5.96; 95% CI 2.24-15.89; P = .0004) and pre-CRT implantation LVEF < 20% (HR 5.63; 95%CI 2.19-14.47; P = .0003), but neither the cardioverter-defibrillator (ICD) implantation (HR 1.00; 95%CI 0.45-2.22; P = 1.00), nor the presence of atrial fibrillation (HR 1.22; 95%CI 0.56-2.64; P = .62), were independently associated with all-cause mortality., Conclusion: Advanced age and an extremely low LVEF, but neither the presence of atrial fibrillation nor implanting an additional high voltage lead, influence the all-cause mortality in patients after long-term RVP, when upgraded to CRT., (© 2020 Wiley Periodicals, Inc.)

Aim: To assess the prevalence of frailty among patients who had cardiac resynchronization as well as the influence of frailty on the main endpoints during follow-up., Methods: The study included 156 patients (aged 74.33 ± 6.75; 27 W) with diagnosed heart failure who were hospitalized for the implantation of a cardiac resynchronization device. The Tilburg Frailty Indicator questionnaire was used to evaluate frailty syndrome., Results: Frailty syndrome was diagnosed in 75.64% of patients who were included. The average value of frailty for the whole group was 6.21 ± 1.94, for the physical domain 4.29 ± 1.32, for the psychological domain 1.40 ± 1.04, and for the social domain 0.51 ± 0.57. During the follow-up period, 5.7% of the patients died, and the mortality rate was not statistically higher (P  =  0.5795) among patients who were diagnosed with frailty syndrome (6.78%) compared to robust patients (2.63%). Analysis of the complications and first electrical storm episodes demonstrated that these events did not occur in patients with no identifiable frailty syndrome. These occurred at a rate of 4.24% (complications) and 2.54% (electric storm) in patients with frailty syndrome., Conclusions: Frailty syndrome can be an important predictor of negative outcomes in patients with heart failure who undergo cardiac resynchronizations., (© 2018 Wiley Periodicals, Inc.)

Background: We hypothesized that patients with de novo cardiac resynchronization therapy (CRT) implantation had a more intense frailty syndrome when compared to the patients who qualified for a system upgrade., Methods: One hundred and six patients aged ≥65 years were included. They were divided into two groups: de novo CRT implantation--74 patients and upgrade from standard right heart pacing--32 patients. A CRT was finally implanted in all of the patients. Frailty was evaluated using the Canadian Study of Health and Aging Clinical Frailty Scale (CSHA-CFS)., Results: The average results in CSHA-CFS were statistically higher (5.3 ± 0.8) in the de novo patients when compared to the patients who qualified for a system upgrade (4.9 ± 0.8); P = 0.027. Frailty syndrome was recognized in 81.1% of the patients in the de novo group and in 68.7% of the patients in the upgrade group; P = 0.164. Only one patient of the 106 had no attributes of frailty (or exposed ones) syndrome., Conclusions: Frailty syndrome is a common phenomenon in patients with heart failure and over 65 years of age. The syndrome is most often recognized in patients who are de novo qualified for cardiac resynchronization., (© 2015 Wiley Periodicals, Inc.)