Brain natriuretic peptide as a screening tool for heart failure in a pacemaker population

AIM:To assess brain natriuretic peptide (BNP) as a screening tool for heart failure in patients with a permanent pacemaker. METHODS: Consecutive patients undergoing a routine permanent pacemaker assessment were enrolled. Patients underwent medical history and examination, echocardiogram and blood sampling for BNP. Analysis was performed in 52 patients (12 DDD, 38 VVI, 2 others; mean age 70±11 years, range: 18-92 years). RESULTS: Nineteen subjects (37%) had heart failure as defined by left ventricular ejection fraction (LVEF) ≤40% and symptoms of heart failure (NYHA class II, III, or IV). At 425 pmol/L, the sensitivity and specificity of screening with BNP were, respectively, 95% and 57% for detecting heart failure in patients under study ［area under the curve (AUC) 0.906, 95% CI 0.860-0.953］. Sensitivity and the specificity were, respectively, 71% and 87% in cases of DDD type pacemakers and were, respectively, 90% and 69% in cases of VVI type pacemakers. CONCLUSION: BNP as an indicator for monitoring patients with cardiac pacemaker implantation is suitable and helpful for assessment of heart failure.