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ARTICLE |

The Care of Patients at Increased Risk of Premature Pacemaker Failure FREE

Lockhart B. McGuire, MD; Stanton P. Nolan, MD
[+] Author Affiliations

Reprint requests to Cardiology Division, Department of Internal Medicine, University of Virginia School of Medicine, Charlottesville, VA 22908 (Dr McGuire).


JAMA. 1979;241(7):701-703. doi:10.1001/jama.1979.03290330017016
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During 1975 to 1977, a series of advisory notices from a pacemaker manufacturer alerted us to an increased probability of sudden, premature pacemaker failure in 217 patients. Three possible responses to these recalls were used among these patients: prophylactic pulse generator change, increased surveillance without pulse generator change, and routine surveillance with replacement only after pacing failure. During the three years after implantation of these pulse generators, 30 sudden failures and 19 incidents of rate decrease indicating impending failure were observed; all were corrected by pulse generator replacement. Among the 50 deaths were six for whom terminal pacemaker status information was inadequate, but overall mortality was not notably different from other pacing series. Consideration of recalls should include projected frequency of failure, expected mode of failure, patient dependence on pacing, and presence of coexisting diseases.

(JAMA 241:701-703, 1979)

REFERENCES

McGuire LB, O'Brien WM, Nolan SP:  Patient survival and instrument performance with permanent cardiac pacing . JAMA 237:558-561, 1977;.
Bette L, Doenecke P, Rettig G, et al:  Results of permanent cardiac stimulation therapy , in Schaldach M, Furman S (eds): Advances in Pacemaker Technology . New York, Springer-Verlag, 1975;, pp 75-82.
Svendsen V, Hildebrandt N, Thygesen K:  Long-term survival of patients with permanent implanted cardiac pacemakers . Dan Med Bull 21:156-160, 1974;.
Nolan SP, Crampton RS, McGuire LB, et al:  Factors influencing survival of patients with permanent cardiac pacemakers . Ann Surg 185:122-127, 1977;.
Davidson DM, Braak CA, Preston TA, et al:  Permanent ventricular pacing: Effect on long-term survival, congestive heart failure, subsequent myocardial infarction, and stroke . Ann Intern Med 77:345-351, 1972;.
Stoney WS, Finger FE, Alford WB, et al:  Natural history of long-term cardiac pacing . Ann Thorac Surg 23:550-554, 1977;.
Bilitch M:  Performance of cardiac pacemaker pulse generators . Pace 1:157-159, 1978;.
Hauser RG, Belie N, Casas N, et al:  Clinical reliability of cardiac pacemakers , abstracted. Circulation 56 ( (suppl 3) ):12, 1977;.
Tyers GFO, Brownlee RR:  Current status of pacemaker power sources . Ann Thorac Surg 25:571-587, 1978;.
MacGregor DC, Noble EJ, Morrow JD, et al:  Management of a pacemaker recall . J Thorac Cardiovasc Surg 74:657-667, 1977;.

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McGuire LB, O'Brien WM, Nolan SP:  Patient survival and instrument performance with permanent cardiac pacing . JAMA 237:558-561, 1977;.
Bette L, Doenecke P, Rettig G, et al:  Results of permanent cardiac stimulation therapy , in Schaldach M, Furman S (eds): Advances in Pacemaker Technology . New York, Springer-Verlag, 1975;, pp 75-82.
Svendsen V, Hildebrandt N, Thygesen K:  Long-term survival of patients with permanent implanted cardiac pacemakers . Dan Med Bull 21:156-160, 1974;.
Nolan SP, Crampton RS, McGuire LB, et al:  Factors influencing survival of patients with permanent cardiac pacemakers . Ann Surg 185:122-127, 1977;.
Davidson DM, Braak CA, Preston TA, et al:  Permanent ventricular pacing: Effect on long-term survival, congestive heart failure, subsequent myocardial infarction, and stroke . Ann Intern Med 77:345-351, 1972;.
Stoney WS, Finger FE, Alford WB, et al:  Natural history of long-term cardiac pacing . Ann Thorac Surg 23:550-554, 1977;.
Bilitch M:  Performance of cardiac pacemaker pulse generators . Pace 1:157-159, 1978;.
Hauser RG, Belie N, Casas N, et al:  Clinical reliability of cardiac pacemakers , abstracted. Circulation 56 ( (suppl 3) ):12, 1977;.
Tyers GFO, Brownlee RR:  Current status of pacemaker power sources . Ann Thorac Surg 25:571-587, 1978;.
MacGregor DC, Noble EJ, Morrow JD, et al:  Management of a pacemaker recall . J Thorac Cardiovasc Surg 74:657-667, 1977;.
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