The Journal of Thoracic and Cardiovascular Surgery, Vol 78, 292-297, Copyright © 1979 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Long-term atrial pacing for sinus node disease with output-terminal programmagle pacemakers
SP Joseph and J White
Long-term transvenous atrial pacing for symptomatic sinus node disease, in
the absence of atrioventricular conduction disease, confers the advantages
of increased cardiac performance and probable freedom from systemic
thromboembolism. Conventional ventricular pacing has been preferred,
however, because of the complications of atrial pacing, mainly those of
electrical and mechanical instability of currently available atrial
electrodes. These complications have been circumvented with a new
pacemaker, programmable for output terminal. This has allowed the
institution of atrial pacing in seven patients, with its attendant
advantages and the ability to reprogram noninvasively to ventricular pacing
should atrial pacing fail. Such reprogramming has been accomplished without
difficulty in one patient who developed second-degree atrioventricular
block and one with electrode microdisplacement.