Permanent cardiac pacing after cardiac operations.
From January 1980 through December 1990, implantation of a permanent pacemaker was performed in 34 patients following open heart surgery. The patients were divided into two groups according to the clinical indications for implantation of permanent pacemakers. Group 1 (9 patients) had surgical atrioventricular block, and Group 2 (25 patients) had sick sinus syndrome. Tricuspid valve surgery was involved in 67% of Group 1 and 64% of Group 2. Adams-Stokes syncopal attack was the prime indication for permanent pacing in 100% of Group 1 and in 72% of Group 2. There were 2 operative deaths in Group 1, and no deaths in Group 2 (22% in Group 1 vs. 0% in Group 2, p < 0.005). Causes of the deaths were not related to the pacemaker implantation but to congestive heart failure following surgery. Among 32 survivors, there were 2 late deaths in Group 1, and 4 deaths in Group 2 (25% in Group 1 vs. 16% in Group 2, p < 0.05). The overall actuarial survival rate at 10 years was 82.1 +/- 2.8%. However, the actuarial survival rate of patients in Group 1 is 70.2 +/- 4.1%, which is statistically less than 85.4 +/- 2.2% in Group 2 (p < 0.01). As judged by these results, patients in Group 1 should be followed on a regular out-patient basis even if they are asymptomatic and there is no evidence of pacemaker failure.
Division of Cardiovascular Surgery, Osaka National Hospital, Japan.
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Otaki
D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D015996:Survival Rate