The Annals of Thoracic Surgery, Vol 24, 62-67, Copyright © 1977 by The Society of Thoracic Surgeons
A recommended protocol for pacemaker follow-up: analysis of 1,705 implanted pacemakers
EL Mantini, RK Majors, JR Kennedy and GR Lebo
This study, developed for the purpose of establishing an appropriate
protocol for general follow-up of the paced patient, is based on clinical
experience with patients derived from diverse specialties, geographical
locations and protocol preferences. The analysis represents a four-year
study of the transtelephonic follow-up of 1,705 implanted cardiac pacers,
which represents 44,616 pacer-months of experience. There were 340 system
malfunctions, 41% (141) due to battery exhaustion and 59% (199) due to
other causes. Of all observed system failures 9.7% (33) occurred within 1
month of implantation, with the rate declining sharply thereafter until
battery failures began to occur at approximately the twenty-fourth month.
Only 10.9% (37) of all system failures were accompanied by clinical
symptoms. Of the clinical failures, 62% (23) occurred in patients who were
tested at intervals greater than 10 weeks. Our analysis indicates that
testing should be performed weekly for the first month following lead
manipulation. Thereafter, tests should be performed at 8- to 10-week
intervals for the first 24 months of pacemaker life. During the third
postimplant year tests should be conducted more frequently, depending on
the energy source of the generator.
