Arrhythmias and Conduction DisturbancesIndications, Effectiveness, and Long-Term Dependency in Permanent Pacing After Cardiac Surgery
Section snippets
Methods
We reviewed hospital charts and outpatient clinic charts of 120 patients who had cardiac surgery at our institution during a 14-year period and had permanent pacemakers implanted within the first 40 days after the operation.
Patient and Preoperative Data:
All the inclusion criteria were met by 120 patients, who were included in the analysis. Of the patients, 57 were men and 63 women, and the median age at operation was 72 years (range 43 to 89). Twenty-five of the patients had a history of significant bradyarrhythmias (either symptomatic bradyarrhythmia or advanced atrioventricular block, pauses >3 seconds, nodal rhythm, atrial fibrillation, or sinus bradyarrhythmia <50 beats/min). All preoperative electrocardiographic patterns are listed in
Discussion
Permanent pacemakers are implanted in 0.8% to 4% of patients with postoperative bradyarrhythmias.1, 2, 3, 4, 5, 6 Risk factors that have been described in the literature for development of significant postoperative bradyarrhythmias include valvular surgery,3, 4, 5, 13 older age,1, 3 preexisting bundle-branch block,1, 3, 5 certain coronary anatomies,9, 11 certain cardioplegia solutions,7, 8, 10 and long bypass or aortic cross-clamp time.[2]
In this study, we used retrospective long-term data
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Dr. Glikson’s work was supported in part by an educational grant from Medtronic Inc., Minneapolis, Minnesota.