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[A 36 years experience with implantable pacemakers. A historical analysis]
Juan Dubernet1, Gastón Chamorro, Jorge González
1Departamento de Enfermedades Cardiovasculares, Facultad de Medicina, Pontificia Universidad Católica de Chile. fduberne@rdc.cl
Background:
The implantation of pacemakers improves cardiac function and quality of life, in particular with dual chamber DDD and DDDR modes.
Aim:
To evaluate our clinical experience and results on pacemaker implantation, from 1963 to 1998.
Material And 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.