Bouraoui Hatem, Trimech Bessma, Chouchene Sofiane, Mahdhaoui Abdallah, Ernez Hajri Samia, Jeridi Gouider, Ammar Habib
Service de Cardiologie, Hopital Farhat Hached, Sousse, Tunisie.
Tunis Med. 2011 Jul;89(7):604-9.
Permanent cardiac pacing remains the only effective treatment for chronic, symptomatic bradycardia. In recent years, the role of implantable pacing devices has expanded substantially.
To compare the situation of patients with critical brady arrhythmias before and after pacing focusing on indication for pacemaker implantation, frequency of re intervention and early and late complications.
Retrospective study performed over 24 years between 1984 and 2007 at the department of cardiology of Farhat Hached hospital. A total of 234 patients were included, and the database was formed by the patients' files and the protocols of implantation.
The mean age of patients was 69.5 years. The most frequently reported signs and symptoms before implantation of pace maker were dizzy spells and syncope respectively in 53% and 29.1% of patients. Among the electrocardiographic alterations leading to an indication of pacemaker implantation, atrio-ventricular blocks were the most numerous at 74.4% followed by sinus node disease at 17.1%. Early complications were represented essentially by haematoma and infection of the pocket of pacemaker respectively at 2.9% for each one. After a mean follow up of 6.8 years, 88 patients (45.3%) still free of symptoms. Late complications include lead dislodgement and pacemaker syndrome at 2% for each one.
The results of our study demonstrates that even the rate of complications following pacemaker implantation is not high, the follow-up of patients should be fast, complete, safe, and clear, and should include sufficient documentation.
永久性心脏起搏仍然是慢性症状性心动过缓的唯一有效治疗方法。近年来，植入式起搏装置的作用已大幅扩展。
比较严重缓慢性心律失常患者起搏前后的情况，重点关注起搏器植入指征、再次干预频率以及早期和晚期并发症。
1984年至2007年期间在法哈特·哈谢德医院心脏病科进行了一项为期24年的回顾性研究。共纳入234例患者，数据库由患者病历和植入记录组成。
患者的平均年龄为69.5岁。植入起搏器前最常报告的体征和症状分别是头晕发作和晕厥，分别占患者的53%和29.1%。在导致起搏器植入指征的心电图改变中，房室传导阻滞最为常见，占74.4%，其次是窦房结疾病，占17.1%。早期并发症主要表现为血肿和起搏器囊袋感染，各占2.9%。平均随访6.8年后，88例患者（45.3%）仍无症状。晚期并发症包括导线脱位和起搏器综合征，各占2%。
我们的研究结果表明，即使起搏器植入后的并发症发生率不高，对患者的随访也应迅速、全面、安全且明确，并且应包括充分的记录。
