[Trends in indications for permanent cardiac pacing therapy at the Cardiac Pacing Center in Eastern Slovakia 1978-1994].

At the Third Medical Clinic, which acts as a cardiostimulation centre for the eastern Slovak area, in 1978 to 1994 1 581 primary implantations and 996 reimplantations of pacemakers were made. In the group of primary implantations the mean age of patients was 70.7 +/- 10.9 years, the male/female ratio was 850/731. In the group of reimplantations the mean age was 71.3 +/- 11.6 years, incl. 483 men and 513 women. There is an almost linear rise of primoimplantations. In the group of reimplantations we can observe a two-peak shape of the curve with a maximum in 1986 and in 1990. While in 1978 atrioventricular block grade III accounted for almost 90% indications for primary implantations, during subsequent years its ratio declined gradually and at present it has reached a steady level of 30-40%. The second most frequent dysrhythmia in the group is dysfunction of the sinoatrial node which in 1978 accounted for 6% of the indications, while in 1994 it accounts for 28% of the primary implantations. In 1978 only non-programmable pacemakers VVI/V00 were implanted. In 1989 on a wider scale multiprogrammable ventricular single electrode systems VVIM were introduced which in 1994 accounted for 58% of the implanted pacemakers. Stimulation with adaptable frequency (VVIR, AAIR) and physiological stimulation of two cavities incl. VDD stimulation accounted for 42% in 1994. It can be summarized that during the last five years marked extension of physiological stimulation occurred with an opportunity to select the optimal mode of stimulation, to increase reliability and keeping qualities of the implanted pacemakers and to improve the perspectives of patients needing cardiostimulation therapy.