Fifty-two patients with sinoatrial disturbances causing syncope, dizzy spells, heart failure or predisposition to ventricular tachyarrhythmias were treated with permanent cardiac pacing between January 1966 and June 1970. They were followed up from 12 to 60 months. The rhythm disorders treated with permanent pacer implantation were: (1) sinus bradycardia (27 patients); (2) sinoatrial block or arrest (10 patients); (3) brady-tachyarrhythmia syndrome (11 patients); and (4) sinus bradycardia with ventricular tachyarrhythmia (4 patients). Forty-seven patients had ventricular and 5 had coronary sinus pacemakers. Two of the five patients with coronary sinus pacemakers subsequently required ventricular pacing because of failure of the coronary sinus electrode to capture the atrium. One patient died 3 weeks after pacemaker implantation because of renal failure. Eleven others died of natural causes 3 to 38 months after implantation of the pacemaker. Long-term pacemaker complications such as perforation of the right ventricle, displacement or fracture of the pacing electrode, infection at the site of the powerpack and raised threshold were observed in nine patients. Syncopal or near syncopal episodes were abolished in 32 of 35 patients, chronic congestive heart failure was alleviated in 7 of 12 patients, and recurrent ventricular tachyarrhythmias were controlled in 3 of 4 patients by pacing and antiarrhythmic agents. We conclude that permanent ventricular pacing is an effective therapeutic approach in sinoatrial disturbances causing symptoms such as syncope, dizzy spells, brady-tachyarrhythmia syndrome, heart failure or recurrent ventricular arrhythmias.
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine