Clinical experience with the isotopic cardiac pacemaker.

Clinical experience with isotopic pacemakers in 59 patients is compared with that in 77 control patients having conventional chemical battery-powered pulse generators. The review covers a 51/2-year period. Statistical analysis of the two series is impossible because of the numerous variables such as age, type of disease, number of controls, types of test and control pulse generators, dates of insertion, and protocol regulations. However, there were pulse generator failures in the control group, but not in the test group. Though not proven in this study, the isotopic cardiac pacer is likely to last longer than conventional chemical battery-powered units, and could provide lifetime pacing for many patients. The risk of carcinogenesis is minimal and seems negligible in older patients. The isotopic cardiac pacer, in spite of restrictions of the Nuclear Regulatory Commission, should be considered for any patient with a life expectancy of 10 or more years. Paradoxically, it might be indicated in older rather than younger patients.