Santini M, Rocchi M, Ialongo D, Masini V
G Ital Cardiol. 1978;8(2):232-7.
The Authors have re-examined their case histories of 1503 patients who have had 2459 pacemakers implanted and who have undergone check-ups as outpatients. All the complications which have arisen from 1967 to the present have been taken into consideration. The total number of complications has been found in 355 patients with 14% of the total number of pacemakers and they have been subdivided into 3 groups: 1st group: complications arising during the stay in hospital (110); 2nd group: complications arising after discharge from hospital and discovered by the patient (239); 3rd group: complications found casually during outpatients' check-ups (6). Of the complications found after discharge, 97% belong to the second group and only 3% to the third group. 657 substituted pacemakers have also been taken into consideration with the purpose of finding out the parameters which showed up as the battery was running down. Out of 145 pacemakers substituted because of flat batteries, 130 (90%) have shown brusque variations in the frequency of stimulation, while only 15 (10%) have shown variations in other parameters (width, length of impulse, etc). The Authors therefore retain that a periodic outpatients' check-up of the pacemakers is of little use as regards the patients' safety and the complete utilization of the device, while they advise that the patient be educated so as to be able to carry out his own daily control of the pacemaker.
作者重新审查了1503例植入2459个起搏器并作为门诊病人接受检查的患者的病历。考虑了自1967年至今出现的所有并发症。在355例患者中发现了并发症,占起搏器总数的14%,这些并发症被分为3组:第一组:住院期间出现的并发症(110例);第二组:出院后出现并由患者发现的并发症(239例);第三组:门诊检查时偶然发现的并发症(6例)。在出院后发现的并发症中,97%属于第二组,只有3%属于第三组。还考虑了657个更换的起搏器,目的是找出随着电池电量耗尽而出现的参数。在因电池耗尽而更换的145个起搏器中,130个(90%)显示刺激频率有突然变化,而只有15个(10%)显示其他参数(宽度、脉冲长度等)有变化。因此,作者认为,就患者安全和设备的充分利用而言,定期门诊检查起搏器用处不大,同时他们建议对患者进行教育,使其能够对起搏器进行日常自我检查。