[A 36 years experience with implantable pacemakers. A historical analysis].
BACKGROUND
The implantation of pacemakers improves cardiac function and quality of life, in particular with dual chamber DDD and DDDR modes.


OBJECTIVE
To evaluate our clinical experience and results on pacemaker implantation, from 1963 to 1998.


METHODS
Computerized data collected from 2,445 consecutive paced patients was reviewed. A total of 3,554 operative procedures were performed, including 412 procedures for complications and 697 pacemaker replacement. Patient survival was determined from clinical records, inquiry to pacemaker manufacturers and death certificates from Servicio de Registro Civil e Identificación de Chile (Chilean Civil and Identification Registry).


RESULTS
Use of dual chamber (DDD and DDDR) pacemakers increased progressively up to 74% from 1988 to 1998. Complication rate was 42% in the 1963-1976 study period, it decreased to 10.6% in the 1977-1987 study period, and to 5.6% by 1988-1998. Only two patients died during surgery in the study period (0.08%). In the 1977-1987 period, pacemakers lasted 10.6 years. Survival rates were 52% at ten years, 33% at 15 years, and 21% at 20 years, with a median survival of 11.7 years, and 7.24 years in patients over 80 years old.


CONCLUSIONS
Transvenous permanent pacing can be accomplished today with a low complication rate, mainly due to better technology and surgical procedures.
Dubernet
Juan
J
Departamento de Enfermedades Cardiovasculares, Facultad de Medicina, Pontificia Universidad Católica de Chile. fduberne@rdc.cl
Chamorro
Gastón
G
González
Jorge
J
Fajuri
Alejandro
A
Jalil
Jorge
J
Casanegra
Pablo
P
Maturana
Gustavo
G
Morán
Sergio
S
Zalaquett
Ricardo
R
Irarrázaval
Manuel J
MJ
Urzúa
Jorge
J
Rodríguez
José A
JA
Braun
Sandra
S
Corbalán
Ramón
R
González
Rolando
R
Marchant
Eugenio
E
D000368:Aged; D000369:Aged, 80 and over; D002304:Cardiac Pacing, Artificial / Q000379:methods / Q000401:mortality; D002423:Cause of Death; D016009:Chi-Square Distribution; D002677:Chile / Q000453:epidemiology; D016001:Confidence Intervals; D004567:Electrodes, Implanted / Q000145:classification; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial / Q000009:adverse effects / Q000706:statistics & numerical data*