The first seven years of implantation of permanent cardiac pacemakers in a small urban community in central Croatia.

The aim of the study was to assess the situation with implantation of cardiac pacemakers and to critically evaluate the possibility of this method of treatment. The study was conducted from 2001 to 2007. Data on a total of 211 operations were included in the study. There were 121 (57.3%) male patients, mean age 69.7 years, and 90 (42.7%) female patients, mean age 74.5 years. Total number of operations increased from 18 in 2001 to 24 in 2002, 28 in 2003, 38 in 2004, 38 in 2005, 30 in 2006 and 35 in 2007. Primo implantation was carried out in 196 (92.9%) cases. The following types of pacemakers were used: VVI in 79 (40.3%), VVIR in 73 (37.2%), DDD in 7 (3.6%), DDDR in 18 (9.2%), VDD in 17 (8.7%) and AAIR in 2 (1.0%) cases. ECG indication was second degree heart block in 40, third degree heart block in 86, chronic atrial fibrillation with bradyarrhythmia in 57, sick sinus syndrome in 27 cases and trifascicular block in one case. The symptoms included dizziness in 126, syncope in 52, dyspnea in 45, bradycardia in 12, chest pain in 3 and cerebral dysfunction in 2 cases. In conclusion, our patients now receive appropriate treatment within a shorter time, thus reducing pressure upon large cardiac surgery centers. However, efforts should be continuously invested in approaching European standards of artificial pacemaker implantation.