Study on Impedance of Implantable Cardiac Pacemaker in Unipolar/Bipolar Pacing Mode by in Vitro Experiment / 中国医疗器械杂志

The unipolar/bipolar pacing mode of pacemaker is related to its circuit impedance, which affects the battery life. In this study, the in vitro experiment scheme of pacemaker circuit impedance test was constructed. The human blood environment was simulated by NaCl solution, and the experimental environment temperature was controlled by water bath. The results of in vitro experiments showed that under the experimental conditions similar to clinical human parameters, the difference between the circuit impedance of bipolar mode and unipolar mode is 120~200 Ω. The results of the in vitro experiment confirmed that the circuit impedance of bipolar circuit was larger than that of unipolar mode, which was found in clinical practice. The results of this study have reference value to the optimization of pacing mode and the reduction of pacemaker power consumption.

Perfil clínico e evolução de pacientes com infecção relacionada a dispositivos cardíacos eletrônicos implantáveis / Clinical profile and outcome of patients with cardiac implantable electronic device-related infection

Resumo Fundamento Houve aumento expressivo na incidência de infecções relacionadas a dispositivos cardíacos eletrônicos implantáveis (DCEI) nos últimos anos, com impacto na mortalidade. Objetivos Verificar a proporção de pacientes com infecção de DCEI e analisar seu perfil clínico, as variáveis relacionadas com a infecção e sua evolução. Método Estudo retrospectivo, observacional e longitudinal com 123 pacientes com infecção de DCEI entre 6.406 procedimentos. Foram usados os testes paramétricos, e o nível de significância adotado na análise estatística foi de 5%. Resultados A idade média dos pacientes foi de 60,1 anos, e 71 eram homens. A média de internação foi de 35,3 dias, e houve remoção total do sistema em 105 pacientes. Identificaram-se endocardite infecciosa (EI) e sepse em 71 e 23 pacientes, respectivamente. A mortalidade intra-hospitalar foi 19,5%. Houve associação entre EI e extrusão do gerador (17,0% vs. 19,5% nos grupos com e sem EI, respectivamente, p = 0,04; associação inversa) e sepse (15,4% vs. 3,2%, p = 0,01). Houve associação entre morte intra-hospitalar e EI (83,3% vs. 52,0% com e sem morte, respectivamente, p = 0,005) e sepse (62,5% vs. 8,1%, p < 0,0001). Foi dada alta hospitalar a 99 pacientes. Durante a média de seguimento clínico de 43,8 meses, a taxa de mortalidade foi de 43%, e 65,2% dos pacientes com sepse faleceram (p < 0,0001). A curva de sobrevida de Kaplan-Meier não indicou associação significante com sexo, agente etiológico, fração de ejeção, EI e modalidade de tratamento. A taxa de mortalidade foi de 32,8% entre os pacientes submetidos a reimplante de eletrodos por via endocárdica e 52,2% entre aqueles por via epicárdica (p = 0,04). Não houve influência da etiologia chagásica, a qual correspondeu a 44,7% das cardiopatias de base, quanto às variáveis clínicas e laboratoriais ou à evolução. Conclusões A taxa de infecção foi de 1,9%, com predomínio em homens. Houve associação entre mortalidade intra-hospitalar e EI e sepse. Após a alta hospitalar, a taxa de mortalidade anual foi de 11,8%, com influência de sepse durante a internação e o implante epicárdico. (Arq Bras Cardiol. 2021; [online].ahead print, PP.0-0)

Abstract Background In recent years, the incidence of infections related to cardiac implantable electronic devices (CIED) has increased sharply, impacting mortality. Objective To verify the proportion of patients with CIED infection; to analyze their clinical profile and the variables related to the infection and its progression. Methods Retrospective and longitudinal observational study including 123 patients with CIED infection among 6406 procedures. Parametric tests and a level of significance of 5% were used in the statistical analyses Results The mean age of patients was 60.1 years and mean length of stay in hospital was 35.3 days; most (71) patients were male, and the system was completely removed in 105 cases. Infectious endocarditis (IE) and sepsis were observed in 71 and 23 patients, respectively. Intra-hospital mortality was 19.5%. IE was associated with extrusion of the generator (17.0% vs 19.5% with and without IE, respectively, p = 0.04, inverse association) and sepsis (15.4% vs 3.2%, p = 0.01). Intra-hospital death was associated with IE (83.3% vs 52.0% with and without intra-hospital death, respectively, p = 0.005) and sepsis (62.5% vs 8.1%, p < 0.0001). Ninety-nine patients were discharged. During a mean follow-up of 43.8 months, mortality rate was 43%; among patients with sepsis, it was 65.2% (p < 0.0001). By applying a Kaplan-Meier survival curve, we did not indicate significant associations with sex, etiologic agent, ejection fraction, IE, or treatment modality. The death rate was 32.8% for patients subjected to endocardial electrode reimplantation and 52.2% for epicardial reimplantation (p = 0.04). Chagasic etiology (44.7% of the baseline heart diseases) did not influence clinical and laboratory variables or disease progression. Conclusion The infection rate was 1.9%, mostly in men. We observed an association of intra-hospital mortality with IE and sepsis. After discharge, the annual mortality rate was 11.8%, influenced by sepsis during hospitalization and epicardial implantation. (Arq Bras Cardiol. 2021; [online].ahead print, PP.0-0)

Implante de marcapasos en un centro de Uruguay (2010-2019). Seguimiento y análisis / Pacemaker implant in a center in Uruguay (2010-2019). Monitoring and analysis / Implante de marcapasso em um centro no Uruguai (2010-2019). Monitoramento e análise

Resumen: Descripción y análisis de los procedimientos de implante de marcapasos en el servicio de electrofisiología institucional en un período de nueve años. Se analiza en forma retrospectiva un total de 1.265 procedimientos. La mediana de edad al momento del implante fue de 77 años, con predominio del sexo masculino. El bloqueo auriculoventricular y la enfermedad del nódulo sinusal fueron las indicaciones más frecuentes. El modo de estimulación predominante fue el bicameral secuencial en menores de 80 años. La mediana de seguimiento fue de 45 meses y hubo seguimiento completo en 90,7% de los pacientes. Se observó una baja tasa de complicaciones (0,8%).

Summary: Description and analysis of permanent pacemakers implantation procedures at the institutional electrophysiology laboratory in a 9-year period. A total of 1265 procedures were retrospectively reviewed. Median age of implantation was 77 years, with men being the majority. Atrioventricular block and sinus node disease were the most frequent indications. Sequential dual chamber pacing was the most common programming mode in patients under 80 years old. The average follow-up was 45 months and there was a complete follow-up in 90.7% of the patients. A low complication rate was observed (0.8% of procedures).

Resumo: Descrição e análise dos procedimentos de marcapassos implantados no serviço de eletrofisiológia institucional, em um período de 9 anos. Um total de 1.265 procedimentos foram revisados retrospectivamente. A mediana de idade do implante foi de 77 anos com predominância de sexo masculino. El bloqueio atrioventricular e doença do nó sinusal são as indicações mais freqüentes. O modo predominante de estimulação foi o bicameral secuencial em los menores de 80 anos. O seguimento médio foi de 45 meses e houve acompanhamento completo em 90,7% dos pacientes. Uma baixa taxa de complicações foi observada (0,8% dos procedimentos).

Salvaging Exposed Cardiac Pacemakers Using Sub–Pectoral Pocket And Negative Pressure Wound Therapy

Introduction: Permanent cardiac pacemakers implanted over chest wall are prone to exposure and infection. The management of exposed pacemaker implants are controversial, and most of the time exposed devices are removed and a second device is implanted in an additional operation after days to weeks. Methods: Between Apr 2014 and Mar 2018, 24 patients were managed for exposed cardiac pacemakers. Most patients were operated within 14 days from exposure. All patients received perioperative appropriate antibiotics. In the absence of clinical signs of infection, NPWT was started for patients where there was more than one gauze piece soakage in 24 hours. Once soakage was less than 10 ml/day, implant was covered with local skin flap or placed in a sub–pectoral pocket and NPWT applied over the suture line. Mean follow–up post salvage procedure was 20 months. Results: Twenty two devices were saved. Only one grossly infected pacemaker was removed. In another patient implant got infected and exposed after four months of re–implantation and has to be removed and replaced. Conclusions: This protocol allows salvage of exposed permanent cardiac pacemaker implants even several days after exposure. A combination of NPWT and sub–pectoral muscle placement lead to salvage of the implant, saving cost and morbidity to the patient.

Design of Cardiac Pacemaker Based on Low Power MCU / 中国医疗器械杂志

In order to improve the accuracy of the pacemaker's parameter adjustment and to avoid the surgical replacement of the pacemaker when the battery is exhausted, this paper designs a novel single-chamber pacemaker circuit based on low-power single-chip microcomputer. The circuit uses digital control to accurately control the amplitude, pulse width and frequency of the pacing pulse. The circuit is also designed with wireless charging function, and wireless communication with the programmer can wirelessly charge the pacemaker and know the charging information in real time. Wireless charging function can reduce the number of times the patient replaces the pacemaker or even completely avoid it.

Comprehension of the education handout and health literacy of pacemaker users / Comprensibilidad de prospecto de facilitación e instrucción en salud de individuos con marcapasos / Legibilidade de prospecto facilitador e letramento em saúde de indivíduos com marcapasso

ABSTRACT Objective: To verify the comprehension of the education handout and the level of Functional Health Literacy of individuals with cardiac pacemaker (PM) and whether there is correlation between the comprehension and Functional Health Literacy (FHL). Method: Cross-sectional study with 63 individuals with PM who answered to comprehension tests of the handout, literacy assessment (SAHLPA-50) and cognition (MMSE). Measurements of dispersion, Pearson correlation and multiple linear regression were calculated. Results: Most women, study time ≤ 9 years, 66.21 (average age) presented no cognitive changes. An adequate literacy level was evidenced in 50.8% individuals with PM and satisfactory comprehension of the handout. No correlation was identified between FHL, handout comprehension, age, years of study and cognition. Conclusion: The handout comprehension assessed by individuals with appropriate FHL indicated that it can be a printed material suitable for use, aiming to improve care process and knowledge of individuals with PM.

RESUMEN Objetivo: Verificar la comprensibilidad de prospecto de facilitación del aprendizaje y nivel de Instrucción Funcional en Salud de individuos con marcapasos cardíaco (MP), y la existencia de correlación entre comprensibilidad e Instrucción Funcional en Salud (IFS). Método: Estudio transversal, con 63 individuos con MP, que respondieron testes de comprensibilidad del prospecto, de evaluación de instrucción (SAHLPA-50) y cognición (MEEM). Se calcularon medidas de dispersión, correlación de Pearson y regresión lineal múltiple. Resultados: Mayoría de mujeres, escolarización ≤ 9 años, media etaria de 66,21 años, sin alteraciones cognitivas. Evidenciado nivel adecuado de instrucción en 50,8% de individuos con MP y comprensibilidad satisfactoria del prospecto. No se identificó correlación entre IFS, comprensibilidad del prospecto, escolarización y cognición. Conclusión: La comprensibilidad del prospecto evaluada por individuos con IFS adecuada indicó que resulta potencial impreso educativo utilizable, en pos de mejorar el proceso de cuidar y el conocimiento de los individuos con MP.

RESUMO Objetivo: Verificar a legibilidade de prospecto facilitador da aprendizagem e o nível de Letramento Funcional em Saúde de indivíduos com marcapasso cardíaco (MP) e se há correlação entre a legibilidade e Letramento Funcional em Saúde (LFS). Método: Estudo transversal com 63 indivíduos com MP, que responderam testes de legibilidade do prospecto, de avaliação do letramento (SAHLPA-50) e cognição (MEEM). Foram calculadas medidas de dispersão, correlação de Pearson e regressão linear múltipla. Resultados: Maioria mulheres, tempo de estudo ≤ 9 anos, idade média de 66,21 anos, sem alteração cognitiva. Evidenciado nível adequado de letramento em 50,8% dos indivíduos com MP e legibilidade satisfatória do prospecto. Não foi identificada correlação entre LFS, legibilidade do prospecto, idade, anos de estudo e cognição. Conclusão: A legibilidade do prospecto avaliada por indivíduos com adequado LFS indicou que pode ser um impresso educativo apropriado para uso, visando aprimorar o processo de cuidar e o conhecimento dos indivíduos com MP.

Research progress on radiotherapy for patients with implanted cardiac pacemaker / 中华放射医学与防护杂志

This article summarizes proposals of different international guidelines,clinical cases in clinical institutions at home and abroad and the latest research progress of tumor patients with implanted cardiac pacemaker.In addition,the various factors during the implementation of radiotherapy were analyzed.It is possible that reducing the risk grade and minimizing the unfavorable factors for pacemaker could be achieved by designing the scientific treatment plan and setting the reasonable radiotherapy plan.The radiotherapy plan can be established safely and effectively in malignant tumor patients with implanted pacemaker.

Remnant Pacemaker Lead Tips after Lead Extractions in Pacemaker Infections

Complete hardware removal is recommended in the case of patients with cardiovascular implantable electronic device (CIED) infections. However, the complete extraction of chronically implanted leads is not always achieved. The outcomes and optimal management of CIED infections with retained material after lead extractions have not been elucidated. In this case report, we present five patients with CIED infections with remnant lead tips even after lead extractions. Two patients had localized pocket infections, and were managed with antibiotics for a period of more than two weeks. The other three patients had infective endocarditis, and were managed with antibiotics for a period of more than four weeks. In one patient, the lead tip migrated to the right pulmonary artery, but did not produce any symptoms or complications. Only one of five patients experienced a resurgence of an infection.

Effects Analysis of Special Rectification of Antibiotics for Prophylactic Use in Perioperative Period of Per-manent Cardiac Pacemaker Implantation in Our Hospital / 中国药房

OBJECTIVE:To provide reference for rational prophylactic application of antibiotics in perioperative period of per-manent cardiac pacemaker implantation. METHODS:600 cases performed permanent cardiac pacemaker implantation in 2010(be-fore rectification),2012(during rectification)and 2014(after rectification)were randomly sampled from our hospital,and divided into control group,intervention group one and intervention group two. The prophylactic application of antibiotics was investigated and analyzed in 3 groups. RESULTS:For control group,intervention group one and intervention group two,the rates of rational type selection of antibiotics for prophylactic use were 7.25%,31.00% and 91.96%,respectively. The rates of rational medication timing of antibiotics for prophylactic use were 0,100% and 100%;average duration of prophylactic use decreased from (3.6 ± 1.2)d before intervention to(1.1±0.5)d and(1.0±0.2)d. There was no statistical significance in the incidence of postoperative infection(P>0.05). Compared with control group,average drug cost,antibiotics cost and drug ratio decreased significantly in in-tervention group,with statistical significane (P<0.05). CONCLUSIONS:Antibiotics special rectification is effective and improve the rational application of antibiotics in our hospital.

The Impact of Autocapture Function on the Service life of Cardiac Pacemaker / 昆明医科大学学报

Objective This study aimed to estimate the impact of the threshold of Autocapture algorithm on the pacemaker's service life.Methods Seventy-four patients implanted with VVI pacemaker were retrospectively evaluated.Among them,48 were implanted with pacemaker of autocapture function.Diagnostic data were retrieved from device memory.Pacemaker's service life was estimated according to the working flow and voltage.Results (1) The average working voltage of the control group and the observation group was (2.8 ± 0.4) V and (1.1 ± 0.4)V respectively.The difference was statistically significant;(2) The battery life in the observation group was (12.59 ± 0.55) a,significantly longer than that in the control group (6.74 ± 1.12) a,with an 86.8％ increase of the device's estimated service life (P＜0.05).Conclusion The Autocapture function results in a significant service life of cardiac pacemaker and represents valuable clinical technology.

Observation for the Effect of Vacuum Sealing Drainage in Treating the Patients With Pacemaker Pocket Infection / 中国循环杂志

Objective: Pocket infection in patients after total removal of implanted pacemaker has many problems for their electronic system; our research intends to explore the feasibility of conservatively treating such infection and retain the electronic system. Methods: A total of 4 patients with pacemaker pocket infection in our hospital from 2015-01 to 2016-02 were studied. Thorough debridement and disinfection were conducted in infected pockets and devices, meanwhile vacuum sealing drainage was applied. Electrode wire was kept and intravenous antibiotics were given for (7-10) days after the operation in all patients. Results: The average time of infection occurred at 14.75 months after operation with the type of isolated pacemaker pocket infection. Pocket vacuum suction drainage was performed, with the mean of 7.25 (5-10) months follow-up observation, infection was disappeared and the patients had good wound healing. Conclusion: With thorough debridement of infected pocket, rational treatment of residual electronic system and vacuum sealing drainage, the infection might be effectively controlled for complete recovery without lead extraction in relevant patients.

Study of left ventricular diastolic function in patients with DDD pacemaker implantation for sick sinus ;syndrome during atrioventricular conduction and right ventricular apex pacing mode / 中华超声影像学杂志

Objective To analyze the left ventricular (LV) diastolic function parameters of patients with sick sinus syndrome (SSS) and DDD pacemaker implantation during atrioventricular conduction (AVC) and right ventricular apex pacing(RVAP)mode.Methods Forty-six consecutive patients with SSS who had undergone DDD pacemaker implantation were studied.Fifty volunteers were selected as control group.Changing from AVC to RVAP mode,the acute effect on echocardiographic left ventricular diastolic function parameters,including mitral inflow PW parameters,mitral annulus tissue Doppler imaging parameters,left atrial volume index,and LV∕apical∕basal untwist parameters were measured.And all subjects were classified into normal diastolic function or three degrees of LV diastolic dysfunction.Results Compared with control group,both AVC and RVAP mode of patients with DDD pacemaker implantation resulted in the worsening of LV diastolic function as shown by(1) prolonged deceleration time of E wave, decreased descending slope of E wave,as well as decreased early diastolic velocity at the septal mitral annulus,(2) the decrease of LV∕basal∕apical untwist velocity,(3) the increase in the degree of diastolic dysfunction.Conclusions In patients with DDD pacemaker implantation,both AVC and RVAP mode are associated with the deterioration of LV diastolic function,which is particularly obvious in RVAP mode.

Transvenous Implantation of a DDDR Pacemaker in a Patient with Extracardiac Conduit Fontan Circulation / 대한내과학회지

As the survival rate of patients with complex congenital heart disease has improved and the number of adult patients with congenital heart disease has risen, arrhythmias and heart failure have become important issues in these patients. Cardiac implantable electronic devices, including pacemakers, are also on the rise. Transvenous implantation or epicardial pacemaker implantation is challenging in patients with complex congenital heart disease. Here we report a case in which a dual-chamber pacing, dual-chamber sensing, dual response and rate-adaptive (DDDR) pacemaker was implanted transvenously into a patient with congenital heart disease. A 34-year-old male with extracardiac conduit Fontan circulation complained of dizziness; an electrocardiogram revealed junctional bradycardia. We performed transvenous implantation of a DDDR pacemaker via trans-conduit puncture. In conclusion, transvenous implantation of a pacemaker is feasible in patients with extracardiac conduit Fontan circulation.

Experience of family caregivers in nursing perioperative patients undergoing permanent cardiac pacemaker:a qualitative study / 现代临床护理

Objective To investigate the experience of family caregivers in nursing perioperative patients undergoing permanent cardiac pacemaker. Methods Twenty-five family caregivers taking care of the patients undergoing permanent cardiac pacemaker participated in the non-structural study. Data were analyzed by phenomenological procedure. Result The factors by category analysis includes fear, anxiety and uneasiness due to preoperative lack of relevant knowledge and postoperative lack of caring experience, lowered health level of the caregivers, strong demand for health education and lack of confidence in home care. Conclusions The family caregivers′ experience varies with different phases in perioperative period. Nurses should provide personalized services to enhance the continuity of home care so as to enhance the care quality.

Effect of Telmisartan Combined with Benazepril on Plasma Brain Natriuretic Peptide of Patients Underwent Permanent Cardiac Pacemaker Implantation / 中国药房

OBJECTIVE:To exlpore the effect of telmisartan combine with benazepril on plasma brain natriuretic peptide (BNP) of patients underwent permanent cardiac pacemaker implantation. METHODS:96 patients underwent permanent cardiac pacemaker implantation were randomly divided into group A,B and C with 32 cases in each group. Based on routine treatment, group A was given telmisartan 80 mg/d immediately after operation,qd,group B given benazepril 10 mg/d,qd,group C given telmisartan 40 mg/d+ benazepril 10 mg/d,qd. All of them was given medicine for 6 months. LEVF,CI,Ren,BNP,AngⅡ and Ald were compared among 3 groups. RESULTS:After 6 months,BNP levels of 3 groups were higher than before,with statistical significance (P0.05);those of group A and B were decreased,with statistical significance(P<0.05);those of group C were higher than those of group A and B, with statistical significance(P<0.05). The levels of Ren,AngⅡ and Ald in 3 groups were decreased after treatment,with statisti-cal significance (P<0.05);those of group C were lower than those of group A and B,with statistical significance (P<0.05). CONCLUSIONS:Telmisartan combined with benazepril can improve ventricular remodeling and heart function,and reduce plasma BNP levels in patients underwent permanent cardiac pacemaker implantation.

Transvenous Pacemaker Lead Removal in Pacemaker Lead Endocarditis with Large Vegetations: A Report of Two Cases

Pacemaker lead endocarditis is treated with total removal of the infected device and proper antibiotics. The outcomes of patients undergoing percutaneous lead extraction for large vegetations (>2 cm) have not yet been shown. In this case report, we present two patients with pacemaker lead endocarditis with large vegetations of maximum diameter 2.4 cm and 3.2 cm. The first patient had multiple vegetations attached to the tricuspid and mitral valves and developed septic emboli to the brain, lung, and liver. The second patient had a large, persistent vegetation on the tricuspid valve, even two weeks after complete removal of the leads. Both patients were successfully treated with transvenous pacemaker lead removal and antibiotics.

Implantation of a permanent pacemaker through the coronary sinus in a patient who underwent mechanical valve replacement for infective endocarditis with a complete atrioventricular block / 영남의대학술지

A 52-year-old man was referred to our hospital due to fever and myalgia that occurred 2 weeks earlier. He showed a complete atrioventricular block on his electrocardiogram, and his vital signs were unstable. On his transthoracic echocardiograph, the 1.5 cm vegetation in the aortic valve with severe aortic regurgitation suggested infective endocarditis. His transesophageal enchocardiograph showed abscess in his mitral-aortic intervalvular fibrosa and vegetation was suspected on his anterior mitral valve leaflet. The patient underwent an emergent operation for valve replacement with temporary epicardial pacing. Intraoperatively, the septal leaflet of his tricuspid valve was injured during the debridement of the abscess pocket that was extended to the membranous septum. The aortic, mitral, and tricuspid mechanical valves were replaced with annular reconstruction without complications. After 14 days of intravenous antibiotics, we successfully changed the epicardial pacemaker into a transvenous DDD-type permanent pacemaker by placing a left ventricular lead via the coronary sinus and an atrial lead in the right atrium appendage. The patient was discharged in a tolerable state and was examined uneventfully in our hospital's outpatient clinic for 8 months.

Comparative study on left ventricular systolic function in patients with implanted dual-chamber(DDD) mode cardiac pace-makers using two-dimensional and real-time three-dimensional echocardiography / 中国医师杂志

Objective To assess the left ventricular systolic function (LVSF) in patients with implanted dual-chamber(DDD) mode cardiac pacemakers using Two-dimensional Echocardiography (2DE),Real-time Tri-plane Echocardiography (RT-3PE)and Full-volume Three Dimensional Echocardiography (FV-3DE).Methods A total of 30 patients with DDD mode cardiac pacemaker were ex-amined by 2DE, RT-3PE and FV-3DE separately.Left ventricle end diastolic volume (LVEDV), left ventricle end systolic volume (LVESV), and ejection fraction (EF) were measured and compared within the three methods above .Results The measurement of EF with patients of post-operation was higher than the patients of pre-operation.The measurements of EF with 2DE were higher than RT-3PE.The measurements of LVEDV , LVESV and SV with 2DE and RT-3PE were lower than FV-3DE, and EF was higher .There were statistically significant differences in above measurements ( P 0.05).Conclusions Implanting DDD mode cardiac pace-maker can evaluate LVSF of patients obviously .FV-3DE can evaluate LVSF in patients with DDD mode cardiac pacemaker accurately . The LVEDV, LVESV and SV are underestimated by 2DE and RT-3PE, and EF is overestimated by 2DE and RT-3PE.

The Follow-up Study for Clinical Compliance in Patients With Permanent Pacemaker Implantation / 中国循环杂志

Objective: To analyze the current condition and inlfuencing factors for clinical compliance in patients with permanent pacemaker implantation and to improve the follow-up condition in relevant patients. Methods: A total of 817 patients with permanent pacemaker implantation in our hospital from 2006-01 to 2013-01 were retrospectively studied. The clinical compliance condition and inlfuencing factors were accessed for 1 year period. Results: There were 26/817 (3.18%) patients lost contact and 1 patient died. A total of 790 (96.7%) patients finished the followed-up study by 2 groups: Clinical visit group,n=440 (55.70%) and Telephone visit group,n=350 (44.30%). The education level, medical cost, residency, comprehension of arrhythmia and accompany personnel were different between 2 groups,P<0.05. The patients were with high school education or above, reimbursed medical cost, local residency, comprehension of arrhythmia and accompany personnel had the higher clinical visit rate. The overall 1 year occurrence rate of complication was 1.8% without severe event. There were 59.5% of patients optimized the pacemaker parameters during clinical visit. Conclusion: The patients with permanent pacemaker implantation had the lower rate of clinical follow-up visit which should be improved in several issues.