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Related Experiment Videos

Permanent cardiac pacing after cardiac operations

M Otaki1

  • 1Division of Cardiovascular Surgery, Osaka National Hospital, Japan.

Artificial Organs
|May 1, 1993
PubMed
Summary

Permanent pacemaker implantation after heart surgery is crucial for patients with atrioventricular block or sick sinus syndrome. Those with atrioventricular block showed lower survival rates, necessitating regular outpatient follow-up.

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Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Electrophysiology

Background:

  • Permanent pacemaker implantation is a common procedure following open heart surgery.
  • Indications for permanent pacing include atrioventricular block and sick sinus syndrome.
  • Tricuspid valve surgery and Adams-Stokes syncopal attacks are significant factors in pacing decisions.

Purpose of the Study:

  • To evaluate the outcomes of permanent pacemaker implantation in patients after open heart surgery.
  • To compare the survival rates and complications between patients with surgical atrioventricular block and sick sinus syndrome.

Main Methods:

  • A retrospective study of 34 patients who underwent permanent pacemaker implantation between January 1980 and December 1990.
  • Patients were divided into two groups: Group 1 (surgical atrioventricular block) and Group 2 (sick sinus syndrome).
  • Data collected included surgical history, indications for pacing, operative and late mortality, and actuarial survival rates.

Main Results:

  • Operative mortality was 22% in Group 1 versus 0% in Group 2 (p < 0.005), primarily due to congestive heart failure.
  • Late mortality was 25% in Group 1 and 16% in Group 2.
  • Ten-year actuarial survival was significantly lower in Group 1 (70.2%) compared to Group 2 (85.4%) (p < 0.01).

Conclusions:

  • Permanent pacemaker implantation outcomes differ significantly between patients with atrioventricular block and sick sinus syndrome post-cardiac surgery.
  • Patients with surgical atrioventricular block exhibit poorer long-term survival.
  • Regular outpatient monitoring is recommended for asymptomatic patients with atrioventricular block, even without signs of pacemaker failure.

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