Reducing permanent pacemaker requirements following concomitant surgery for atrial fibrillation

摘要

1 , INTRODUCTION: The need for a new permanent pacemaker (PPM) is not uncommon following open-heart surgery as many operations implant devices such as valves, rings, or sutures near the atrioventricular (AV) node. Manipulating the heart with incisions, retractors, and "lifting" the heart for bypass grafts may cause transient dysrhythmias. When there are pre-existing conditions such as sick sinus syndrome or bundle branch block the postoperative dysrhythmias may become permanent. Surgery for atrial fibrillation (AF) is associated with the need for a new PPM. Whenever possible cardiac surgeons and electrophysiolo-gists prefer to avoid a PPM to preclude the possible associated complications such as tricuspid regurgitation, pacemaker infection, pacing dyssynchrony, and the potential need for lead extraction, which can be risky, especially if leads were placed more than 10 years prior.