Proceedings: Pacemaker implantation bradycardia and cardiac insufficiency. Preliminary report]

The longterm effects of pacemaker therapy have been investigated in 337 patients with bradycardia and congestive heart failure with or without Adams-Stokes syncope. The cumulative survival rate in patients with Adams-Stokes seizures without congestive heart failure (group I) is markedly better than in patients with Adams-Stokes seizures and congestive heart failure (group II). The death rate is highest in patients with congestive heart failure as sole indication for pacemaker implantation (Group III). In the patients from group II (mainly with slight to moderate decompensation) there was a higher percentage of improvement than in those from group III (chiefly with severe congestive heart failure), in whom cardiac decompensation improved in approximately half the cases. These findings do not prompt excessive enthusiasm about the longterm results in patients with bradycardia and severe congestive heart failure. The indication subsists where there is resistance to drug therapy, or digitalis intolerance, or where treatment with a provisional pacemaker produces good results.