RESUMO
We report a 15 year experience in the attention of patients with definitive pacemakers. This study includes 200 patients treated from 1964 to 1978, with an age range from 15 to 102 years, who required 329 generators. The predominant cardiopathy was atheroesclerotic (172 cases). We analyze the associated diseases in which hypertension was prominent in 30% of these cases. The most frequent rhythm alteration was atrioventricular block in 72% of the cases, and trifascicular block in 16%. We observed 35 intercurrent complications (17.5%), and the most frequent was infection of the generator bag. Mortality in these patients averaged 11%, being strictly imputable to the pacemaker in only 2%. Eighty patients needed generator change and we report a case who required up to six changes. The implantation of permanent pacemakers for treatment of patients with severe arrhythmias is considered at present secure and effective.
Assuntos
Arritmias Cardíacas/terapia , Marca-Passo Artificial , Adolescente , Adulto , Idoso , Arritmias Cardíacas/complicações , Doença das Coronárias/complicações , Complicações do Diabetes , Falha de Equipamento , Feminino , Bloqueio Cardíaco/terapia , Humanos , Hipertensão/complicações , Masculino , Pessoa de Meia-Idade , Complicações Pós-OperatóriasRESUMO
Se informa la experiencia de quince anos, en la atencion de pacientes con marcapasos definitivos. El estudio incluye 200 pacientes, tratados en el lapso de 1964 a 1978, con edades entre 15 y 102 anos, que requirieron 329 generadores. El tipo de cardiopatia predominante fue la ateroesclerosa con 172 casos. Se analizan las enfermedades asociadas destacando la hipertension arterial sistemica en el 30% de los casos. El trastorno del ritmo con mayor frecuencia determinante de la indicacion de colocar un marcapaso fue el bloqueo auriculoventricular (72% de los casos), seguido del bloqueo trifascicular en el 16%. Se observaron 35 complicaciones (17.5%), de las cuales la mas frecuente fue la infeccion de la bolsa del generador. El promedio de mortalidad en estos pacientes fue del 11%, siendo en forma estricta imputable al marcapaso solo el 2%. Ochenta pacientes necesitaron cambios de generador e informamos un caso que requirio hasta 6 cambios. La implantacion de marcapasos permanentes para el tratamiento de pacientes con arritmias graves se considera en la actualidad seguro y efectivo, permitiendo una mejoria en la duracion y calidad de vida
Assuntos
Adolescente , Adulto , Pessoa de Meia-Idade , Humanos , Masculino , Feminino , Marca-Passo ArtificialRESUMO
This is a report of the use of transvenous temporal pacemaker in 18 patients, with an average age of 59.3 years, that under want non cardiac major surgery. They did not have cardiac simptoms but had conduction abnormalities in the preoperative electrocardiogram. A pacemaker was implanted as a prophylaxis against arrythmia during the transoperative and postoperative periods. There was no incidence of transoperative arrythmia. Three patients died in the immediate postoperative period, two due to duffuse carcinomatosis and one due to diabetic acidosis. The average duration of the implanted pacemaker was 12.7 days, and three patients required a permanent pacemaker. Case five is exemplificative of the benefits of the temporal pacemaker, he had a preoperative electrocardiogram showing trifascicular block, he was taken to the operating room and anesthesia was induced, the patient had a cardiac arrest but recovered without secuela; latter on a temporal pacemaker was inserted and the patient had surgery without cardiac problems.