January 12, 1979Acta Medica Scandinavica
Sick Sinus Syndrome Treated with Permanent Pacemaker in 109 Patients
Why the study?
Does permanent pacemaker implantation improve symptoms and what is the prognosis in patients with sick sinus syndrome?
Population
109 patients with sick sinus syndrome treated with permanent pacemakers
Design
Cohort
Follow-up
mean 34.4 months
Authors
Discussion
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Implication
Pacemaker implantation was associated with symptom relief in sick sinus syndrome; leaves open whether tachy-brady patients need targeted antithrombotic strategies.
Key Points
- To assess long-term clinical outcomes, symptom resolution, and complication rates in patients with sick sinus syndrome treated with permanent pacemakers.
- Followed 109 patients with sick sinus syndrome receiving permanent pacemakers between 1966 and 1976 over a mean follow-up of 34.4 months.
- Stratified patients into tachy-bradyarrhythmia (n=44) and bradyarrhythmia (n=65) groups to analyze mortality, conduction disorders, and systemic embolization.
- Symptomatic improvement occurred in 104 of 109 patients, with syncope reducing from 68 patients pre-implantation to only 3 post-implantation.
- Total mortality reached 9.3% per year (29 deaths overall), with no significant difference observed between the tachy-bradyarrhythmia and bradyarrhythmia cohorts.
- Systemic embolization occurred in 16 patients overall, presenting at a significantly higher rate in the tachy-bradyarrhythmia group (12/44, 27.3%) than the bradyarrhythmia group (4/65, 6.2%) (p < 0.001).
Structured PICO
Does permanent pacemaker implantation improve symptoms and what is the prognosis in patients with sick sinus syndrome?
P
Population
109 patients with sick sinus syndrome (SSS) treated with permanent pacemakers (44 with tachy-bradyarrhythmias, 65 with bradyarrhythmias)
I
Intervention
Permanent pacemaker implantation
O
Outcome
Symptomatic improvement, mortality, and systemic embolizationhard clinical
Permanent pacemakers provide excellent symptomatic relief in patients with sick sinus syndrome, though systemic embolization risk is significantly higher in those with tachy-bradyarrhythmias.
Cite This Study
BREIVIK et al. (1979) studied this question.