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Arquivos Brasileiros de CardiologiaResumos das Próximas Publicações
Ano 2001Atrioventricular Pacemaker. Incidence and Causes of Reprogramming in Long-term Follow-Up
Martino Martinelli Fº, Sylton de Arruda Melo, Silvana A. D. Nishióka, Anísio A. A. Pedrosa, Sérgio Freitas de Siqueira, Roberto Costa, Eduardo Sosa English version by Stela Maris C. Gandour
Objective – To assess the incidence of problems requiring reprogramming of atrioventricular pacemakers in a long-term follow-up, and also the causes for this procedure. Methods – During the period from May ’98 to December ’99, 657 patients were retrospectively studied, 355 of whom were males. Their ages ranged from 7 to 92 years (mean = 58 years of age). Indications for pacemaker implantation were as follows: total atrioventricular block in 359 patients, type II second degree atrioventricular block in 138 patients, sick sinus syndrome in 115 patients, hypersensitivity of the carotid sinus in 34 patients, long QT syndrome in 8 patients, and others in 3 patients. The heart diseases were as follows: Chagas’ heart disease in 227 patients, ischemic heart disease in 196 patients, hypertensive heart disease in 92 patients, valvar heart disease in 71 patients, congenital heart disease in 28 patients, and others in 43 patients. An actuarial curve for the event reprogramming of the stimulation mode was drawn. Results – The follow-up period ranged from 12 to 178 months (mean = 81 months). Eighty-two (12.4%) patients underwent reprogramming of the stimulation mode as follows: 63 (9.5%) changed to VVI,(R/C); 10 (1.5%) changed to DVI,C; 6 (0.9%) changed to VDD,C; and 3 (0.5%) changed to DOO. The causes for the reprogramming were as follows: arrhythmia conducted by the pacemaker in 39 (37.6%) patients; loss of atrial sensitivity or capture, or both, in 39 (38.6%) patients; and microfracture of atrial electrode in 5 (4.9%) patients. The probability of no reprogramming of the stimulation mode after 15 years was 58%. Conclusion – In a long-term follow-up, the atrioventricular pacemaker provided a low incidence of complications, a high probability of permanence in the DDD,C mode, and the most common cause of reprogramming was arrhythmia conducted by the pacemaker. Key words – atrioventricular pacemaker, reprogramming, DDD,C mode
Mailing address: Martino Martinelli Fº – InCor – Av. Dr. Enéas C. Aguiar 44 – 05403-000 – São Paulo, SP, Brazil
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