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Long‐Term Survival After Permanent Pacemaker Implantation in Young Adults: 30 Year Experience
Author(s) -
MAYOSI BONGANI M.,
LITTLE FRANCESCA,
MILLAR ROBERT N. SCOTT
Publication year - 1999
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.1540-8159.1999.tb00468.x
Subject(s) - medicine , permanent pacemaker , heart disease , sick sinus syndrome , etiology , heart block , surgery , population , young adult , pediatrics , cardiology , electrocardiography , environmental health
The goal of the present study was to determine the etiology of conduction disease and long‐term outcome for young adults who undergo permanent pacemaker implantation. Permanent pacing was performed in 232 patients aged 21–50 years, 135 males and 97 females, from 1965 through 1995. One hundred and twenty‐six subjects (54%) had evidence of structural heart disease, while idiopathic conduction disease accounted for 46%. About half (54%) of 106 patients with structural heart disease had surgically induced heart block. Pacing mode at primary implantation was single chamber in 65% and dual chamber in 35%. Follow‐up ranged from 12–387 months, with a mean of 104–months. At the last follow‐up, 133 of 232 patients (57%) were alive, 40 (17%) had died, 30 (13%) were lost to follow‐up, 26 (11%) were transferred elsewhere, and 3 (1%) explanted. Patients with sick sinus syndrome had similar outcomes to those with AV block. There was a sharp decline in survival during the first six months; 7.5% of the sample died within the first year following their first pacemaker operation. After the first year, the decline in survival slowed and 70% of the patients could be expected to survive beyond 20 years. The overall survival of young patients without structural heart disease who received a permanent pacemaker was comparable to an age‐ and sex‐matched control population, while patients with structural heart disease performed significantly worse than the control population.