[Programming of pacemakers: a gain or a passtime?].

Seventy-seven programmable pacemakers, selected at random from a reservoir of 1051 explanted pacemakers, made available by health-offices, institutes of pathology and institutes of forensic medicine, were examined for alterations made since the time of delivery. The results motivated our choice of title. In 41 of 74 (55.4%) no parameter was changed and in 36.5% the frequency was altered. Of the two- or multi-programmable pacemakers, the amplitude was altered in 13 of 61 (21.3%), the pulse duration in 9 out of 38 (23.7%), the sensitivity in 10 out of 32 (31.3%), hysteresis in one out of 31 (3.2%) and the refractory time in none of 30. None of the 10 pacemakers with programmable operation mode were reprogrammed although they included a DDD that was delivered, however, in the VVI state. Nine of 69 pacemakers (13%) were double- and 2 of 33 (6%) triple-programmed. The two physiological parameters (frequency and hysteresis) were clearly not utilised to the extent that would be desirable. All other programmable parameters serve exclusively for the technical adjustment to the heart.