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Course of Symptoms and Spontaneous ECG in Pacemaker Patients: A 5‐Year Follow‐up Study
Author(s) -
LANGENFELD HEINER,
GRIMM WOLFRAM,
MAISCH BERNHARD,
KOGHSIEK KURT
Publication year - 1988
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1988.tb05986.x
Subject(s) - sick sinus syndrome , medicine , sss* , atrioventricular block , cardiology , permanent pacemaker , heart block , ventricular pacing , electrocardiography , heart failure
We investigated the course of symptoms and the spontaneous ECG retrospectively in 308 patients who had received a pacemaker because of atrioventricular (AV) block fn = 115), sick sinus syndrome (SSS, n = 107), bradyarrhythmic atriai jibriJiation (bradyarrhythmia, n = 51). carotid sinus syndrome (CSS, n = 16), complete bifascicular block associated with 1st degree AV block (n = 13) and with other indications fn = 6). The mean implantation time was 63 months. The clinical state of 93% of all patients improved after pacemaker implantation; their symptoms decreased markedly. Persisting syncopy in some patients with SSS, however, supports a restricted implantation policy. We rarely saw improved AV conduction in patients with AV block fn%). Furthermore, in patients with SSS, atrial fibrillation occured significantly more often (35%) than in those with AV block (17 %; P < 0.01). Only 3% of patients with SSS developed 2nd and 3rd degree AV block within the observation period. In all patients with Initial bifascicular block and additional 1st degree AV block, pacing prevented further syncopal attacks; four of them showed 3rd degree AV block at control, indicating that pacemaker implantation is mandatory in symptomatic patients with bifascicular disease and 1st degree AV block.