Goldschlager N
Division of Cardiology, San Francisco General Hospital, CA 94110.
Postgrad Med. 1988 Mar;83(4):156-9, 162-9, 172-4. doi: 10.1080/00325481.1988.11700191.
The indications for and technology associated with permanent cardiac pacing have undergone major changes during the past decade. In contrast to the 1970s, most patients now receive cardiac pacing devices subsequent to the diagnosis of sick sinus syndrome. However, since this condition is prevalent in elderly patients, it is crucial that indications for pacing be critically evaluated and pacing recommended only for those with documented symptoms or marked abnormalities indicative of high risk for a subsequent cardiac event. This is particularly important because pacing has not been shown to influence survival in these patients. The technological advances in pacing devices during the last ten years now provide many desirable options. As a result, available pacemakers range from very simple to highly complex; accordingly, they have a wide range of prices. It is more important than ever to carefully select the appropriate pacing device for a given patient, since its cost, longevity, and required follow-up may differ greatly.
在过去十年中，永久性心脏起搏的适应症及相关技术发生了重大变化。与20世纪70年代不同，现在大多数患者是在被诊断为病态窦房结综合征后才接受心脏起搏装置。然而，由于这种疾病在老年患者中很常见，至关重要的是要严格评估起搏适应症，仅对那些有记录的症状或明显异常表明随后发生心脏事件风险高的患者推荐起搏治疗。这一点尤为重要，因为尚未证明起搏能影响这些患者的生存率。过去十年中起搏装置的技术进步现在提供了许多理想的选择。因此，现有的起搏器从非常简单到高度复杂不等；相应地，它们的价格范围也很广。为特定患者仔细选择合适的起搏装置比以往任何时候都更重要，因为其成本、使用寿命和所需的随访可能有很大差异。
