Mellat Park, Vali Asr Avenue, Tehran, Iran
Background- Patients with symptomatic sinus node disease require a permanent pacemaker to relieve symptoms. This study was conducted retrospectively in patients who had received a ventricular pacemaker for sick sinus syndrome and was designed to analyze the incidence of complications and long-term survival in sinus node disease treated with ventricular pacing.
Patients and Methods- Eighty-two adult patients between the ages of 20 and 90 years old with symptomatic sinus node disease who received a permanent ventricular pacemaker between 1979 and 1996 at our department were followed to determine the natural history of the disease. 31 had coronary artery disease, 26 had hypertension, 7 had rheumatic valvular heart disease, and diabetes and mitral valve prolapse were present in 7 and 2 patients, respectively. The etiology was unknown in 9 patients.
Results- 3 patients had died during this period because of congestive heart failure and ischemic heart disease. There was a distinct trend toward poor survival in those with congestive heart failure and old age.
Conclusion- The long-term prognosis of symptomatic sinus node disease after permanent ventricular pacing depends on: 1) etiology of underlying heart disease, 2) ventricular function prior to implant, and 3) specific arrhythmias