Twelve years experience of permanent pacemaker malfunctions at Cairo University

ABSTRACT

This study aimed to evaluate the types of pacemaker malfunctions. Out of 578 patients who had permanent PMs, 486 [84.1%] were available for follow up for a mean period of 53 +/- 10.3 months [range from 2 to 130 months]. Pacemaker complications were classified into those due to generator malfunctions and those due to lead problems. The entire period of follow up was divided into first 6 years [82-87] and second 6 years [88-93]. Methods of diagnosis included history, resting 12 lead ECG, magnet test, electronic testing, telemetry, plain X-ray chest, ambulatory ECG, chest wall stimulation, provocative maneuver and lastly invasive testing. From the results obtained it was concluded that increasing rate of implantation with progressive shift from non-programmable to more sophisticated physiologic pacemakers imposed an additional task on implanting physician; namely, diagnosis and mangement of pacemaker malfunctions. Lead problems in the second period of follow up were almost thrice the generator malfunctions reflecting the learning curve of the new generation of operators. However, the increasing incidence of generator malfunctions is related to the longer follow up and better longevity of patients