[Long-term follow-up study after permanent pacemaker implantation in patients aged 60 years or over with sick sinus syndrome].
Ninety-five patients aged 60 years or over with a permanent pacemaker implanted for sick sinus syndrome were divided into two groups: 32 patients with physiological pacing (group P) and 63 patients with ventricular pacing (group V). The mean follow-up period was 45.0 +/- 36.6 months in group P and 50.3 +/- 37.8 months in group V. Paroxysmal atrial fibrillation (Af) occurred in 28% of group P and 71% of group V (p < 0.05). The incidence of stable Af was also lower in group P than in group V (9% vs. 30%, p < 0.05). None of group P with only bradyarrhythmia had stable Af. However, 6 of 21 patients (29%) in group V with bradyarrhythmia showed stable Af. There was no significant difference in stable Af between group P with bradycardia-tachycardia syndrome (BTS) and group V with BTS (19% vs. 31%). A lower incidence of embolic events was also observed in group P (3% vs. 25%, p < 0.05). Nine of 16 patients with embolic events in group V died of complications following embolism (8 patients; cerebral embolism, one patients: renal and superior mesenteric arterial embolism). The survival rates at 5 and 10 years were 80% and 69%, respectively, for group P and 56% and 33% for group V (p < 0.01). Thus, with regard to permanent pacing for patients with sick sinus syndrome, physiological pacing should be selected for control of morbidity and total mortality.
Chida
K
K
Division of Cardiology, Tokyo Metropolitan Geriatric Hospital.
Ohkawa
S
S
Imai
T
T
Suzuki
Y
Y
Ishikawa
K
K
Watanabe
C
C
Kuramoto
K
K
Suzuki
Y
Y
Kaku
T
T
Ueda
K
K
D000368:Aged; D002304:Cardiac Pacing, Artificial / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles; D006801:Humans; D008297:Male; D008875:Middle Aged; D012804:Sick Sinus Syndrome / Q000401:mortality / Q000628:therapy*; D015996:Survival Rate