Permanent Pacemaker Implantation After Cardiac Surgery

The aim of our study was to evaluate the short and long-term results and coınplications of permanent pacemaker implantation after cardiac surgery and to analyze the elinical characteristics of the patient group. Fifty-two patients with permanent pacemakers, which were implanted after a cardiac surgery between April 1988 and December 1997, were analyzed retrospectively. Most of the patients, who necessitated permanent pacemaker implantation postoperatively, had preoperative conduction disturbances (90%). In patients over 18 years old, the most common underlying operations were aortic valve replacement and mitral valve replacements with tricuspid valve replacement (17.3%), while in children it was surgery for correction of atrial septal defect, primum type (28.8%). The most common electrocardiographic diagnosis in the patient group was an escape rhythm secondary to an atrioventricular block with a narrow QRS complex (55.7%). At the end of the 1980s, in our hospital, VVI pacemakers and epicardial leads were implanted in these patients for the management of AV blocks occurring after a cardiac surgery. But recently endocardial leads, VVIR, DDDR, and YDD pacemakers have been implanted. Threshold values for epicardial leads were higher than those for endocardial leads, 0.99 V and 0.50 V, respectively, (p<0.002). The pacemaker pocket bernatorna was the most common acute complication (3.7%), whereas ventricular lead complication was the most common chronic complication (13.3 %).