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Permanent Ventricular Pacing: Effect on Long-Term Survival, Congestive Heart Failure, and Subsequent Myocardial Infarction and Stroke

DENNIS M. DAVIDSON, M.D.; CHARLES A. BRAAK, B.A.; THOMAS A. PRESTON, M.D.; and RICHARD D. JUDGE, M.D., F.A.C.P.
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Presented in part 1 April 1971 at the Fifty-Second Annual Session of the American College of Physicians, Denver, Colo.

▸Requests for reprints should be addressed to Dennis M. Davidson, M.D., Box 137, U.S. Naval Hospital, San Diego, Calif. 92134.


Ann Arbor, Michigan


Ann Intern Med. 1972;77(3):345-351. doi:10.7326/0003-4819-77-3-345
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One hundred and fifty patients with permanent ventricular pacemakers were followed to determine long-term survival statistics, the effect of pacing on congestive heart failure, and the incidence of subsequent myocardial infarction and cerebrovascular accident. A high prevalence of diabetes mellitus in pacing candidates was the only significant atherosclerotic risk. Survival was significantly improved in patients first paced after 1964 compared with those paced earlier. Of 20 patients with preexistent congestive heart failure, 16 markedly improved with pacing. Congestive heart failure occurred for the first time after pacing in 26 patients (17%). Paced patients had 4 myocardial infarctions (expected = 10.6) and 6 cerebrovascular accidents (expected = 7.7). Permanent ventricular pacing produced excellent long-term survival, with no increased risk of myocardial infarction or cerebrovascular accident. Pacing was effective for preexistent refractory congestive heart failure, but congestive heart failure, first appearing after implant, was frequent.

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