Clinical And Electrophysiological Characteristics Of 383 Patients With Permanent Pacemaker Implantation

Objective To analyze the baseline date,concomitant disease,types of arrhythmias,types of pacemakers and pacing site patients undergoing permanent pacemaker implantation for the first time,and to explore the clinical characteristics of patients undergoing permanent pacemaker implantation for the first time of our hospital,so as to serve the clinical work.Methods From January 1,2014 to December 31,2018,383 patients with permanent pacemaker implantation in NingXia were analyzed retrospectively,including the characteristics of age,gender,first symptoms(dizziness,fatigue,palpitation,chest distress,shortness of breath,chest pain,syncope or blackout),concomitant diseases(hypertension,diabetes,coronary heart disease,valvular heart disease,viral myocarditis,cardiomyopathy,cardiac surgery,thyroid dysfunction),types of arrhythmias(sick sinus syndrome,atrioventricular block,branch block,AF with AVB,AF with long R-R interval,double node disease,long Q-T interval syndrome,vasovagal syncope),types of pacemakers(dual chamber,single pacemaker),pacing site(right ventricular apex,right ventricular septum,right ventricular outflow tract,his bundle).Results 1.Of the 383 patients who underwent permanent pacemaker implantation in our hospital,the average age was(68.4 ± 12.1)years(21-96 years),among which 307 were aged ≥ 60 years,accounting for 80.2% of all patients.There were 201(52.5%)males and 182(47.5%)females.The difference between the old group and the non old group was statistically significant(P<0.05).2.Among the patients who underwent permanent pacemaker implantation,⑴177(46.2%)had chest distress and shortness of breath as the first symptoms,177(46.2%)had dizziness,78(20.4%)had palpitation,48(12.6%)had chest pain,55(14.4%)had fatigue,115(30.0%)had syncope,and 5(1.3%)had abnormal ECG only during physical examination.There was no significant difference between the old group and the non old group(P>0.05).⑵There were 47(12.3%)cases of blackout.The difference between the old group and the non old group was statistically significant(P<0.05).3.Of the 383 patients who underwent permanent pacemaker implantation in our hospital,⑴235(61.4%)were accompanied with hypertension,66(17.2%)with coronary heart disease,74(19.3%)with diabetes,7(1.8%)after cardiac surgery and 5(1.3%)with acute viral myocarditis.The difference between the two groups was statistically significant(P<0.05).⑵There were 9 cases of valvular heart disease(2.3%),9 cases of cardiomyopathy(2.3%),5 cases of hyperthyroidism(1.3%),11 cases of hypothyroidism(2.9%),and 2 cases of rheumatoid arthritis(0.5%).There was no significant difference between the two groups(P>0.05).4.Among the patients with bradycardia,213(55.6%)had atrioventricular block,114(29.8%)had sick sinus syndrome,13(3.3%)had branch block,14(3.7%)had atrial fibrillation with atrioventricular block,20(5.2%)had double node disease,6(1.6%)had long R-R interval,2(0.5%)had long Q-T interval syndrome,1(0.3%)had vasovagal syncope.There was no significant difference in arrhythmia types between the two groups(P>0.05).5.Among all the patients,⑴ 274(71.5%)had dual chamber pacemaker and 109(28.5%)had single chamber pacemaker.The difference between the two groups was statistically significant(P<0.05).⑵ 222(58.0%)patients received temporary pacemaker implantation before operation.The active electrode was fixed in 318(83.0%)of right ventricular apex,60(15.7%)of right ventricular septum,4(1.0%)of outflow tract and 1(0.3%)of his bundle.There was no significant difference between the two groups(P>0.05).Conclusion1.The patients who received permanent pacemaker implantation were mainly the elderly,and men were slightly more than women.2.Patients with permanent pacemaker implantation have different clinical manifestations,mainly including chest distress,shortness of breath and dizziness,and they are often accompanied with hypertension,coronary heart disease,diabetes and other elderly diseases.3.In this study,the arrhythmias of patients with permanent pacemaker implantation were mainly the third degree atrioventricular block in atrioventricular block,followed by sinus arrest in sick sinus syndrome.4.In this study,more patients implanted dual chamber pacemaker than single chamber pacemaker,and the active electrode fixation was mainly at the right ventricular apex.