Pacemaker implantation in patients with bradyarrhythmias of known etiology
Lin, J.L.; Lien, W.P.; Chen, J.J.; Chen, J.H.; Hsieh, Y.Y.; Wu, T.L.; Chu, S.H.; Hung, C.R.
Journal of the Formosan Medical Association 85(8): 771-782
1986
ISSN/ISBN: 0371-7682 PMID: 3467020 Document Number: 273861
During the period March 1969-March 1985, a total of 150 patients (pts) with symptomatic bradyarrhythmias including advanced atrioventricular (A-V) block, sinus node dysfunction (SND) or atrial fibrillation (AF) with slow ventricular response received permanent pacemaker therapy. Those patients with old myocardial infarction were excluded. Of the 150 patients, 16 (10.7%) had bradyarrhythmias of known etiology; they were 4 men and 12 women, ranging in age from 18-82 years (44.3 .+-. 18.0 years). Four patients had chronic rheumatic valvular disease (RHD); there was third-degree (3.degree.) A-V block in 3 and AF with slow ventricular response in one. Two patients with primum atrial septal defect (ASD) had 3.degree. A-V block, and 1 patient with ventricular septal defect and patent ductus arteriosus had SND. One patient with infective endocarditis developed persistent 3.degree. A-V block and acute aortic regurgitation. One patient had persistent 3.degree. A-V block complicated with thyroiditis, hypothyroidism and hyporenin-hypoaldosteronism. Symptomatic SND was related to thyrotoxicosis in 3 patients. The remaining 4 patients developed advanced A-V block after cardiac surgery: Ebstein anomaly of the tricuspid valve, 1; primum ASD, 1; and RHD, 2. These patients constitute a special clinical subset with different features from those with the bradyarrhythmias of unknown etiology (idiopathic conduction system disease). They require special management to treat their associated disease in addition to pacemaker therapy.