PT  - JOURNAL ARTICLE
AU  - S K Suvarna
AU  - R D Start
AU  - D I Tayler
TI  - A prospective audit of pacemaker function, implant lifetime, and cause of death in the patient.
AID  - 10.1136/jcp.52.9.677
DP  - 1999 Sep 01
TA  - Journal of Clinical Pathology
PG  - 677--680
VI  - 52
IP  - 9
4099  - http://jcp.bmj.com/content/52/9/677.short
4100  - http://jcp.bmj.com/content/52/9/677.full
SO  - J Clin Pathol1999 Sep 01; 52
AB  - AIM: To audit prospectively the reasons for pacemaker implantation, the duration of the pacemaker use, the cause of death, and pacemaker function after removal from the patient. METHODS: Pacemakers were removed at necropsy, or from the bodies of patients awaiting cremation, in three hospitals over a three year period. The cause of death was taken from the results of the necropsy or from the certified cause of death. Demographic data, including the time of implant and reasons for implantation, were checked. The pacemakers were analysed in terms of battery status, program, and output under a standard 470 ohm load. RESULTS: 69 patients were studied. Average age at death was 78 and 80 years for men and women, respectively. The average duration since pacemaker implantation was 46 months. Eleven patients had necropsies, showing that three died from ischaemic heart disease, six from cardiomyopathy, one from an aortic aneurysm, and one from disseminated neoplasia. From the necropsy results and death certificates, the distribution of causes of death in the group as a whole were ischaemic heart disease (21), cardiomyopathy (8), cerebrovascular disease (11), neoplasia (11), chest infection/chronic obstructive airways disease (8), and other causes (10). In all cases the pacemaker box function was within normal limits. CONCLUSIONS: Neither primary nor secondary pacemaker dysfunction was found. The study highlights the impact of arrhythmias in cardiomyopathy, and raises questions about the true role of ischaemic heart disease in these pacemaker requiring patients. The relatively short gap between pacemaker implantation and death requires further study.