SUBJECTIVE CONSEQUENCES OF PERMANENT PACEMAKER THERAPY - A 5-YEAR PROSPECTIVE FOLLOW-UP

Background: Life prolonging effects of pacemaker therapy are well docu mented. However, data addressing the impact of pacemaker therapy on qu ality of life are limited. The objective of the present study was to a ssess the subjective consequences following implantation of a cardiac pacemaker. Methods: This prospective long-term follow-up study of the subjective consequences of pacemaker therapy in patients more than 50 years of age included 99 consecutive patients undergoing subacute or e lective pacemaker implantation from 1985 to 1986. We examined the pati ents' assessment of symptoms and impact on quality of life before pace maker implantation and in 56 patients (57%) at median follow-up of 62 months (range, 46 to 76 months) later. Results: At follow-up 38 patien ts had died, and five were lost to follow-up due to dementia senillis. In the remaining 56 patients, four reported physical complaints and t hree expressed anxiety or uneasiness because of the pacemaker carrier status. Beneficial effects on symptoms were seen in 51 patients (91%), with the most pronounced effects on symptoms of dizzy spells, syncope , or both. Improvements in quality of life were seen in 32 patients (5 7%). The proportion of patients reporting improvement in quality of li fe following pacemaker therapy was not significantly different between patients who had experienced a change in life quality before implanta tion and patients who had not. Conclusions: Following the implantation of a cardiac pacemaker most patients display a remarkable adjustment to their new situation with an almost negligible level of overt anxiet y or uneasiness; a substantial number report improvements in quality o f life.