The nature and frequency of postimplant surgical interventions: a realistic appraisal.

The purpose of this retrospective study was to investigate the nature and frequency of surgical reinterventions after primary pacemaker implantation in patients who survived at least 20-30 years. Eighty-five such patients were identified, 32 of whom had radioisotopic (nuclear) implants, and 53 lithium battery powered lithium units. Excluding reoperations within the first 3 months, patients with nuclear implants experienced about two reoperations in 25 years, while those with lithium experienced one every 8 years. The most frequent reasons for surgery were pulse generator replacements, lead revisions, and mode changes, particularly in the nuclear group. There were no premature device failures. This study allows us to make reasonable predictions to patients about the experience a pacemaker implantation, and reassures us about the reliability of the devices that were implanted in the past.