title: The atrial pacemaker: retrospective analysis of complications and life expectancy in patients with sinus node dysfunction.
abstract: The safety of atrial pacemakers is still a remaining cause of controversy. Since 1972, we have implanted 111 atrial pacemakers and we were able to follow-up 100 patients continuously. Mean follow-up time was 47 +/- 36 months (maximum 154 months) with a total population time of 391 patient years. Over a period of 10 years, the cumulative incidence of complete atrioventricular block was 4% (2 patients). The cumulative incidence of atrial fibrillation was 11% (5 patients). Lead-related complications were strongly dependent on the type of the lead and the mode of fixation. The cumulative incidence of all lead-related problems was 19% over a period of 5 years and 33% over a period of 10 years. The cumulative survival rate was 85% for 5 years and 61% for 10 years. These survival rates were not different from the survival rate of a matched cohort of the normal population. We conclude that atrial pacing could be done in patients with sick sinus syndrome. The risk of developing a complete atrioventricular block seems to be rather low. The main problem of the atrial pacemaker is the fixation of the lead which could be reduced by using screw-in-type leads.
authors.affiliation: Department of Cardiology, University Hospital Bergmannsheil, Ruhr University Bochum, F.R.G.
authors.forename: B
authors.initials: B
authors.lastname: Lemke
authors.forename: B J
authors.initials: BJ
authors.lastname: Höltmann
authors.forename: H
authors.initials: H
authors.lastname: Selbach
authors.forename: J
authors.initials: J
authors.lastname: Barmeyer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000503:physiopathology; D004562:Electrocardiography; D004868:Equipment Failure; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria / Q000503:physiopathology*; D006801:Humans; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial / Q000009:adverse effects; D012189:Retrospective Studies; D012804:Sick Sinus Syndrome / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*