[Long-term results in electric pacemaker therapy].
It is reported on experiences and results in 317 patients with altogether 690 implantations of pacemakers from 1963 to 1974 and under comparison and with reference to the up to now existing long-term results published in literature state and tendency of the medical and technical development of the electric heart stimulation are discussed. The average age of outpatients was 62.9 years with a peak of age of 46% in the 7th decade of life. 60% were male patients, 40% female ones. With about 50% the constant total atrioventricular block was the most frequent indication. 63% of the familiar types of pacemakers were biotronic apparatuses, 36% of them with fixed frequency. The average duration of the function of all apparatuses was calculated with 20.1 months. Hereby the biotronic types had the longest average function times of 26.7 months (frequency fixed) or 26.3 months (regulated). In 373 reimplantations is shown that 2.17 apparatuses were implanted in each patient. The total number of complications was 21.2% related to the total number of implantations. With 8.9% breaks of the cable were in the first place in myocardial electrodes. Dislocations of transvenous electrodes were observed only in 4.5% of our cases. With 5.8% pressure necroses and infections were the cause of complications stood in the second place concerning frequency. The total lethality was 23.7% with an age peak of 38% in the 8th decade of life. 13.4% of the cases of death belong to an early lethality with a prevailing part of epicardial implantations. In our patients the cumulative survival rate was after 1 year 89.3%, after 5 years 62.3% and after 8 years 47.7%. The 50% survival rate was ca. 7.3 years. In comparison to the population of the same age the average expectance of life is transgressed by about 6 years. The prolongation of the survival time by electrostimulation compared with the conservative treatment of the total atrioventricular block with Adams-Stokes-syndrome is the essential result of the pacemaker therapy.
D000219:Adams-Stokes Syndrome / Q000628:therapy; D000293:Adolescent; D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000209:etiology / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006327:Heart Block / Q000628:therapy; D006333:Heart Failure / Q000150:complications; D006801:Humans; D007223:Infant; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial / Q000592:standards*
Langzeitergebnisse in der Therapie mit elektrischen Herzschrittmachern