Clinical and pathological factors influencing the prognosis of the long-term paced patients.

Abstract

The survival probability, the relation between the prognosis and the changes in cario-thoracic ratio (CTR), and the analysis of the dead cases were studied in our paced patients. The survival in 114 patients demonstrated a rapid decrease within the first one year after cardiac pacing, and there was non significant difference in survival between the paced patients and the general population after one year. Patterns of CTR changes in 57 patients were classified in the following 4 groups. The CTR remained almost unchanged during follow-up years (Type Ia), it first decreased and remained constantly (Type Ib), gradually increased from the beginning of pacing (Type IIb). As to morbidity and mortality in this patients, the cases in Type Ia and Ib showed good prognosis, and the cases in Type IIa and IIb showed poor prognosis. As regard to the rate-output curve in 7 patients, flat type was observed in many cases of Type I, but peaked type was observed in Type II, which suggests that the cardiac function in patients of Type II is decreasing with restricted contractility of the myocardium. Causes of 30 deaths during follow-up periods were analyzed. In the cases which died of congestive heart failure, extensive myocardial degenerative changes underlying atrioventricular block were revealed by necropsies.