Related Experiment Videos
Initial experience with the permanent implantable transvenous pacemaker: a report of 33 patients
Insights
Permanent transvenous pacemaker implantation is a safe and effective treatment for heart block, even in elderly patients. This procedure offers a low complication rate and is the preferred method over older surgical techniques.
Area of Science:
- Cardiology
- Medical Devices
- Geriatric Medicine
Background:
- Heart block necessitates pacing for symptom management and survival.
- Traditional surgical pacing methods carry significant risks, especially in elderly patients.
- Transvenous pacemaker implantation has emerged as a less invasive alternative.
Purpose of the Study:
- To evaluate the safety and efficacy of permanent transvenous pacemaker implantation for heart block.
- To assess the outcomes in a cohort including a high proportion of elderly patients.
- To compare transvenous pacing with historical surgical approaches.
Main Methods:
- Thirty-three patients with heart block underwent permanent transvenous pacemaker implantation.
- Procedures were performed under local anesthesia with fluoroscopic guidance.
- All patients received follow-up examinations, including electrocardiograms.
Main Results:
- No deaths occurred in the study cohort.
- Complications were minimal, despite 25 patients being over 70 years of age.
- The procedure demonstrated high safety and effectiveness in elderly, frail patients.
Conclusions:
- Permanent transvenous pacemaker implantation is a safe, effective, and preferred treatment for heart block.
- The procedure is well-tolerated, even in elderly and debilitated individuals.
- Thoracotomy is now considered obsolete for most heart block cases requiring pacing.
Abstract:
Thirty-three patients with heart block were treated by implantation of a permanent transvenous pacemaker. There were no deaths and few complications even though 25 of these patients were over 70 years of age. Follow-up examinations, including electrocardiograms, were done in all patients.The technique of the operation is discussed and the importance of performing it under fluoroscopic guidance in a proper surgical operating suite is emphasized. This arrangement may require the use of a portable image intensifier.This simple, effective procedure can be performed under local anesthesia and with safety, even in the elderly, frail or debilitated patient. Currently it is the authors' method of choice in the treatment of heart block; thoracotomy is now obsolete unless a synchronous pacemaker is needed or a permanent transvenous pacer cannot be inserted.