[Patients history following artificial aortic valve and pacemaker implantation].
The follow-up of 22 patients (out of 31 patients after artificial aortic valve and pacemaker implantation between 1982 and 2001) have been evaluated. There were 15 men aged 30-76 (x=55) and 7 women aged 43-69 (x=59). Aortic valve replacement (AVR) was subsequently followed by pacemaker implantation (PI) after approximately 16 days. Indication for permanent stimulation were: atrio-ventricular complete block in 18 patients and atrial fibrillation with slow ventricular response in the remaining 4. There were implanted 15 devices of VVI type and 7 of VDD type. The duration of follow up was 9-196 (x=56) months. All these patients remained in good general state (II degree--19 patients or II/III degree--3 patients acc. to NYHA classification). In 21 out of 22 patients, atrioventricular conduction disturbances and bradyarrhythmia remained for the entire follow-up duration with permanent stimulation (VVI or VAT). In one patient the postoperative complete atrio-ventricular block disappeared during follow up, 24 months after AVR.


CONCLUSIONS
1. The main indication for PI after AVR was complete atrio-ventricular block, persisting 2-3 weeks after surgery, without accompanying atrial fibrillation. 2. In long term follow up after AVR and PI (VVI or VDD) the dominance of 100% capture ventricular pacing have been recorded in almost all cases, which holds the decision of early postoperative PI.
Sniezek-Maciejewska
Maria
M
Klinika Chirurgii Serca, Naczyń i Transplantologii Instytutu Kardiologii, Collegium Medicum, Uniwersytetu Jagiellońskiego w Krakowie. maria.maciejewska@interia.pl
Małecka
Barbara
B
Bednarek
Jacek
J
Machejek
Jakub
J
Kapelak
Bogusław
B
Drwiła
Rafał
R
Czunko
Agnieszka
A
Sadowski
Jerzy
J
Lelakowski
Jacek
J
D000328:Adult; D000368:Aged; D001021:Aortic Valve / Q000601:surgery*; D002304:Cardiac Pacing, Artificial; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006327:Heart Block / Q000628:therapy*; D006350:Heart Valve Prosthesis / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D016896:Treatment Outcome