[Permanent cardiac pacing in patients on chronic dialysis]

Four patients on chronic dialysis, who underwent permanent pacemaker implantation, were reviewed. The indication for pacing was sick sinus syndrome in three patients and complete atrioventricular block in one. Physiological pacing modes were chosen in all patients (DDD in three and AAI in one). Sensing and pacing properties in these patients studied at implantation and at follow-up (22-41 months after implantation) were similar as those in non-dialysis patients. However, the study of these properties during hemodialysis showed a significant elevation of atrial pacing threshold associated with marked decrease of serum potassium concentration in two patients. We conclude that dialysis patients with significant bradyarrhythmia should be considered for pacemaker implantation in the same manner as non-dialysis patients. However, special attention should be payed on the elevation of pacing threshold during hemodialysis.