APPRAISAL OF RADIOISOTOPE FUELED PACEMAKERS AFTER 5 YEARS

Personal observation of 131 radioisotope‐powered pulse generators in 120 patients over a period of 5 years has confirmed the expectations of the developers. Actuarial survival of the pulse generator at 5 years was 96 percent. There were only two cases of component failure (1.5 percent) and no battery failures.13 To date there has been no evident toxicity from radiation effects. The total cost of pacing is less with nuclear units than with lithium or with mercury‐zinc powered models. Factors, limiting the use of the pacer are the persistence of nonbattery problems that require premature reoperation, and the unavailability of a truly “modern” pulse generator. Because the nuclear pacers have proved to be effective, relatively inexpensive, and apparently safe, we believe that continued clinical use is justified; the manufacturers, however, should modify the present units by incorporating fully programmable circuits in a pulse generator package much reduced in size. Copyright © 1979, Wiley Blackwell. All rights reserved