LONG-TERM FOLLOW-UP OF PATIENTS WITH CARDIAC PACEMAKERS

One hundred and ninety patients have had implantation of intracorporeal electronic cardiac pacemakers at the Mount Sinai Hospital between September 1962 and May 1967. Transthoracic units were employed in 91 cases (mean follow-up interval 38.5 mo.), and transvenous pacers were used in 99 patients (mean interval 9.9 mo.). One hundred reoperations have been performed, 74 in the transthoracic group and 26 in the transvenous series. Analysis of failure rates at six months following surgery discloses 25 reoperations in 91 patients with transthoracic pacemakers (27%) and 17 reoperations in 64 with transvenous catheter pacemakers (27%). However, the magnitude of the operative procedures has been less in the latter group. There have been 35 deaths, 25 in the transthoracic series and 10 in the transvenous series, although 30-day mortality has been 5 and 3 per cent, respectively. Six month mortality is 15 per cent for the transthoracic pacemaker group and 8 per cent for the transvenous series. Most patients have died from diseases unassociated with their heart block. Comparison of mortality rates for patients with Stokes-Adams syndrome treated medically and surgically reveals that substantial improvement in prognosis has been achieved by the use of implantable electronic pacemakers. © 1968.