Review of cardiac pacing at Maribor teaching hospital since 1972
Abstract
Background: Number of implanted pacemakers is in continuous increase in Maribor General Hospital. The first four pacemakers in 1972 were followed by 50 pacemakers annually in the first 10 years. In 1988 the number first exceeded 100 implanted pacemakers and in the year 2004 achieved number 372. Altogether, till the end of the year 2004 there were 4232 pacemakers implanted. Analyses of the implanted pacemakers according to pacing mode since 1986 shows small number of DDD/VDD(R) pacemakers till the year 1995. Since that year its number was increasing and in the year 1998 and 1999 exceeded half of all implanted pacemakers. In period of thirty years, there were 48.3% VVI, 22.3%VVIR, 16.4% DDD, 5.8% DDDR, 6.1% VDD and 1% AAIR pacemakers implanted. We have done analysis of the all outpatients within the 30-year period (1972–2001). For this purpose 2206 records were reviewed and 2176 patients analysed. According to gender, there were 51.4% male and 48.6% female. Average age at the time of implantation was 71 years (range from 13–96 years). Most patients (58%) were between 65 and 79 years of age, there were 20% younger than 65 years and 22% older than 80 years of age. There were more men in the group till 79 years of age and more women in the group older than 80 years. Average survival of the patients with pacemaker (1771) was 94.7% after one year, 56.9% after five years and 31.5% after ten years. Survival is influenced by the age of the patients and accompanying diseases of the patients at the time of implantation, especially heart failure. In patients younger than 65 years, five years survival from implantation, was 75.4% and after ten years 54.3%. In older than 80 years, five years survival from implantation was 34.4% and after ten years 11.5%. Survival of the patients with heart failure, five years after implantation was 10% and after ten years 8% worse than those without it. In 30-year period, 271 patients had two or more pacemakers implanted, leading by a patient with 7 implanted pacemakers in 27-year period. Analysis of average pacemaker longevity showed that the longest longevity had pacemakers Stanicor L (9.5 yrs), followed by Activitrax (8.7 yrs) and Multicor (8.5 yrs). On average, DDD pacemakers have shorter longevity than VVI pacemakers, especially devices using rate-adaptive pacing on minute ventilation (Meta DR). Cost comparison of pacemakers treatment to other widespread therapeutic methods, place the pacemakers among cheap and effective methods of treatment.
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