Sinoatrial disorders, the "sick sinus" syndrome. Experience with implanted cardiac pacemakers

The long term results of permanent pacemaker implantation in patients with disorders of the sinoatrial node and atrial conduction pathways were studied. In a consecutive series of 300 patients treated by pacemaker implantation, 68 ((22.3%) had sinoatrial disorders. Mean age of the group was 54 years (33-82 years); 37 were male, 31 female. Diagnosis was confirmed by serial electrocardiography with overdrive suppression of sinoatrial node function as indicated. Twenty-two patients presented with sinus bradycardia alone (Type I disorder) and 46 with bradycardia-tachycardia syndrome (Type II disorder) were completely controlled. of the 46 Type II patients, in 30 (65.2%) tachyarrhythmias were controlled by pacing alone and in 14 (30.4%) by pacing and antiarrhythmic drug therapy. Congestive cardiac failure was relieved in 80% and anginal pain in 70% of patients with rate control alone. Systemic embolisation did not recur after pacemaker implantation. The average duration of pacemaker therapy was 52 months (12-96 months). In this series, long term ventricular demand pacing proved beneficial in both types of sinoatrial disorders.