Key result
Permanent ventricular pacing improved preexistent refractory congestive heart failure in 16 of 20 patients and showed no increased risk of myocardial infarction.
Why the study?
Does permanent ventricular pacing improve survival and affect the incidence of congestive heart failure, myocardial infarction, and cerebrovascular accident in patients with pacemakers?
Cohort (n=150)
Does permanent ventricular pacing improve survival and affect the incidence of congestive heart failure, myocardial infarction, and cerebrovascular accident in patients with pacemakers?
Permanent ventricular pacing provides excellent long-term survival and improves preexistent refractory congestive heart failure without increasing the risk of MI or CVA, though new-onset heart failure is frequent.
Answers are grounded in this paper and cite their sources.
Should not yet change practice; hypothesis-generating for pacing benefit in refractory heart failure.
One hundred and fifty patients with permanent ventricular pacemakers were followed to determine long-term survival statistics, the effect of pacing on congestive heart failure, and the incidence of subsequent myocardial infarction and cerebrovascular accident. A high prevalence of diabetes mellitus in pacing candidates was the only significant atherosclerotic risk. Survival was significantly improved in patients first paced after 1964 compared with those paced earlier. Of 20 patients with preexistent congestive heart failure, 16 markedly improved with pacing. Congestive heart failure occurred for the first time after pacing in 26 patients (17%). Paced patients had 4 myocardial infarctions (expected = 10.6) and 6 cerebrovascular accidents (expected = 7.7). Permanent ventricular pacing produced excellent long-term survival, with no increased risk of myocardial infarction or cerebrovascular accident. Pacing was effective for preexistent refractory congestive heart failure, but congestive heart failure, first appearing after implant, was frequent.
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Dennis M. Davidson (1972) conducted a cohort in Permanent ventricular pacemakers (n=150). Permanent ventricular pacing vs. Expected population rates / historical pacing (pre-1964) was evaluated on Long-term survival, congestive heart failure, myocardial infarction, and cerebrovascular accident. Permanent ventricular pacing improved preexistent refractory congestive heart failure in 16 of 20 patients and showed no increased risk of myocardial infarction.
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