Sick sinus syndrome and high-degree atrioventricular block in dementia with Lewy bodies and other dementia subtypes: A study of ≈ 73,000 patients with dementia

INTRODUCTION: Lewy body pathology is commonly found in cardiac nervous tissue, including the cardiac conduction system. This study aimed to investigate the occurrence of sick sinus syndrome (SSS) and high-degree atrioventricular block in dementia with Lewy bodies (DLB) compared to Alzheimer's disease (AD) and other dementia subtypes.

METHODS: We included 73,619 individuals diagnosed with dementia from the Swedish Dementia Registry. Data pertaining to incident pacemaker implantation was obtained from the Swedish Pacemaker Registry.

RESULTS: SSS was more common in the DLB compared to the AD cohort (2.2% vs. 1.5%, P = 0.008). In adjusted models, SSS was associated with DLB compared to AD (odds ratio, 1.49; 95% confidence interval: 1.11-2.01).

DISCUSSION: We showed that incident pacemaker implantation secondary to SSS was more common in patients with DLB compared to those with AD.

HIGHLIGHTS: Incident pacemaker implantation secondary to sick sinus syndrome (SSS; but not high-degree atrioventricular block [HAVB]) was more common in dementia with Lewy bodies (DLB) versus Alzheimer's disease (AD).In adjusted models, SSS (but not HAVB) was positively associated with DLB compared to AD.Pacemaker data of various dementia disorders are presented.