The Annals of Thoracic Surgery, Vol 23, 550-554, Copyright © 1977 by The Society of Thoracic Surgeons
The natural history of long-term cardiac pacing
WS Stoney, FE Finger, WC Alford Jr, GR Burrus, RA Frist and CS Thomas Jr
During the past ten years, 504 patients have received one or more
pacemakers for complete heart block or other arrhythmia. Of these patients,
306 (61%) are alive. Actuarial analysis shows a steady attrition of 9.4%
per year for the first five years, decreasing to 7% per year for the second
five years. The overall survival was decreased for patients with congestive
heart failure and advanced age and was not affected by the history of
Stokes-Adams attacks, initial pulse rate below 50 per minute, or a QRS
duration greater than 0.12 second prior to pacing. Cardiac problems were
the primary cause of death in 71% of the patients. The natural history of
patients with permanent pacemakers depends, more than any other factor, on
the function of the left ventricle.