Objectives: To investigate the relationship between abdominal obesity and long-term prognosis in patients with a pacemaker.

Methods: In the SUMMIT Study, patients were categorized by baseline waist circumference into obesity, normal, and lean groups. WC was measured at the midpoint between the last rib and hip bone after exhalation. Regular follow-ups were conducted, with all-cause mortality as the primary endpoint and cardiac death as the secondary endpoint.

Results: In total, 492 patients were included in the analysis. The average baseline waist circumference was 84.2 ± 12.7 cm, and abdominal obesity was observed in 37.6% of patients. During a mean follow-up of 67.2 ± 17.5 months,71 death due to any cause (14.40%) and 24 cardiac death (4.87%) events occurred. All-cause mortality was associated with higher waist circumference (87.6 versus 83.6 cm, P = 0.014), but not body mass index (23.6 versus 23.5, P = 0.930). Multivariate Cox analysis showed compared with patients with abdominal obesity, lean patients had a significant lower risk in both all-cause mortality (HR 0.188, 95%CI 0.070-0.505, P = 0.001) and cardiac death (HR 0.097, 95% CI 0.012-0.792, P = 0.029).

Conclusions: Baseline waist circumference less than 80 cm for men and less than 75 cm for women in patients with a pacemaker had a significant lower risk in long-term all-cause mortality and cardiac death.

Keywords: All-cause mortality; Body mass index; Pacemaker; Waist circumference.

© 2025. The Author(s).

目的： 探讨腹型肥胖与起搏器患者长期预后之间的关系。

方法： 在SUMMIT研究中，根据基线腰围将患者分为肥胖组、正常组和瘦体型组。WC是在呼气后的最后一根肋骨和臀骨中间位置测量的。定期进行随访，并以全因死亡率为主要终点，心脏死亡为次要终点。

结果： 总共纳入了492名患者进行分析。基线腰围平均值为84.2 ± 12.7 cm，37.6%的患者存在腹型肥胖。在平均随访期为67.2 ± 17.5个月期间，发生了71例全因死亡（占14.40%）和24例心脏死亡（占4.87%）。所有原因导致的死亡与较高的腰围有关（分别为87.6 cm 和 83.6 cm, P = 0.014），但与体重指数无关（分别为23.6 和 23.5，P = 0.930）。多变量Cox分析表明，与腹型肥胖患者相比，瘦体型患者的全因死亡风险显著较低（HR 0.188, 95%CI 0.070-0.505, P = 0.001），心脏死亡的风险也显著降低（HR 0.097, 95% CI 0.012-0.792, P = 0.029）。

结论： 对于起搏器患者，基线腰围小于80 cm（男性）和75 cm（女性），其长期全因死亡率和心脏死亡风险显著降低。

关键词： 全因死亡；体重指数；起搏器；腰围。