[Five years' experience with an epimyocardial screw-in electrode in cardiac pacemakers]

197 myocardial sutureless screw-in electrodes were implanted between the years 1973 and 1978. A subxyphoidal transmediastinal route and general anaesthesia were used. All patients had initially good pacing results. In 93% the electrode was placed into the right, in 7% into the left ventricle. The peroperative mortality rate was 0, peroperative complications were seen in 1%. Of the 19% of the complications which needed some kind of a treatment, 7.6% were confined to the lead and 11.4% were other complications. The lead, placed into the right ventricle, had to be replaced in five patients (2.7%) because of exit block or sensing problems. The postpericardiotomy syndrome was the most frequent complication but it did not impair the function of the pacemaker. 4% of the patients died within 30 days after the implantation. In 46 patients the pacemaker was replaced after a mean time of 32,5 months. The measurement of the threshold rose from a mean of 0.8 mAmp to 3.2 mAmp and the mean resistance was 530 Ohms. In 44 patients the electrode could be reused.