Should we revascularize before implanting a pacemaker?

Clinical Cardiology
Murat YesilNursen Postaci


The effect of coronary revascularization on disappearance of the severe conduction disturbances is still unclear. We sought to determine whether revascularization may induce recovery of sinus rhythm in patients with significant coronary artery disease and complete atrioventricular block (AVB). Fifty-three patients who had third-degree AVB and significant coronary artery disease were enrolled. Patients with acute coronary syndromes were excluded. Thirty-three (62%) patients were men and the mean age was 65 +/- 10 y. All patients received a permanent dual-mode, dual-pacing, dual-sensing (DDD) pacemaker. Coronary disease was treated medically in 16 (30%) patients due to patient preference or ineligibility. Thirty-seven (70%) patients underwent a revascularization procedure (coronary artery bypass grafting [CABG]: 16, percutaneous coronary intervention [PCI]: 21 pts). Mean follow-up was 36 +/- 6 mo and patients were evaluated every 3 mo according to their resting electrocardiograms (ECGs) at each visit. In the medically treated group, 13 (81%) patients still had third-degree AVBs at the end of the follow-up period, while 3 (19%) patients returned to normal sinus rhythm. On the other hand, 27 out of 37 patients (73%) who were revasc...Continue Reading


Feb 24, 2005·Journal of Cardiac Surgery·Suat Nail OmerogluCevat Yakut

Related Concepts

Coronary Artery Disease
Sinus - General Anatomical Term
Entire Coronary Artery
Coronary Arteriosclerosis
Atrioventricular Block
Coronary Artery
Artificial Cardiac Pacemaker
Cardiac Pacing, Artificial
Sinus brand of acetaminophen-pseudoephedrine

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