[The experience in cardiac pacing at the Cardiology Department of St. Camillo Hospital (Rome) (author's transl)]

Abstract

The experience of the Cardiac Electrostimulation Center of S. Camillo Hospital in Rome on 1503 patients treated with permanent pacemakers for an 11 year period is referred. The Authors analyze the increase of the activity of the Center during these years and some events that caused it. 94.5% of the patients were more than 50 years old; the dominant pathology has been ischemic and idiopathic cardiopathy, which together include 94.7% of the totality. The indication to the implant has been A-V block in 70% of the patients; intraventricular block in 20%; sick sinus syndrome in 10%. In the last years the prophylactic indication has increased (from 0.4% to 4.4%). 2459 pacemakers have been used, of which 79.5% was QRS-inhibit. The mercury prosthesis have been progressively substituted with the lithium ones. 1642 catheters (implant and reimplant) have been used; principally endocardic (95%) and monopolar (85%). The substitution of the catheter has been necessary in 9% of the totality; in 2.6% of the endocardic and in 15.9% of the epimyocardic. Among 50 electrodes, after a period of observation of about 7.7 years, 36 are still in function. The percentage of the complications has been 17.1%; the most important complications have been: dislocation (6%), microdislocation (1.5%), late high threshold (2.1%), failure of catheter (1.2%), generator malfunction (2.3%). The total mortality has been 15.4%; 0.2% caused by deficit of the implant; 2% sudden deaths and 13.2% not depending from the implant; 243 patients (16%) are not to be found. The frequency of out-patients controls has decreased in the last 2 years (from 3.8 controls per years to 1.8).