Sinus node dysfunction. Clinical outcome and results of cardiac pacing

: 112 patients (average age 66 +/- 13 years) with sinus node dysfunction, selected on clinical, electrocardiographic and electrophysiological criteria, were followed up for a period of 3 to 55 months (average: 30,2 months). Permanent cardiac pacing was instituted in 59 patients (52,6 p. 100), and the remaining patients treated medically. 25 patients were lost to follow up (22,3 p. 100: 5 paced, 20 non paced). 16 patients died (14,2 p. 100): mortality was relatively early (average 11,7 months) and higher in patients with pacemakers (15/16); the causes of death were acute heart failure (8 cases), and cerebral vascular accident (3 cases). In the surviving paced patients neurological symptoms completely regressed. In this series, the life expectancy of patients with sinus node dysfunction seemed to depend mainly on the state of their myocardium, but the functional prognosis was clearly improved by cardiac pacing.