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The Annals of Thoracic Surgery, Vol 23, 550-554, Copyright © 1977 by The Society of Thoracic Surgeons

ARTICLES

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.