Methods: The study group consisted of 496 patients in whom a DDD pacing system was implanted between October 1984 and March 2002 and who were followed up until July 2010. The follow-up period was 152.1 +/- 35.5 months. The patients’ mean age at the time of implantation was 59.5 +/- 12.5 years, and 53.5% were male; 58% had sick sinus syndrome (SSS), 26% had atrioventricular block (AVB), 15% had both of these indications simultaneously, and 1% had other indications. The incidence of lead malfunction, progression to chronic atrial fibrillation
(AF), and the rate of infective complications was analysed. Results: During the follow-up, 369 patients remained in DDD mode stimulation. DDD mode survival mTOR inhibitor rate at one, five, ten and 15 years was, respectively, 96%, 86%, 77% and 72%. The most common reason for reprogramming out of DDD mode was the development of permanent AF in 65 (13.1%) patients. The
occurrence of chronic AF RG-7388 inhibitor was associated with a prior history of paroxysmal AF (p = 0.0001), SSS (p = 0.0215), and older age at time of implantation (p = 0.0068) compared to patients who remained in sinus rhythm. Lead malfunction caused loss of DDD mode pacing in 56 (11.3%) patients. Atrial leads were damaged in 37 patients, ventricular in 12 patients, and both leads in seven patients. The subclavian vein puncture was correlated with the mechanical damage of the atrial lead (p = 0.02935) compared to cephalic vein access. At the moment of complication, the patients with a dysfunctional lead were significantly younger than those who progressed to chronic AF (p = 0.0019). Infective complications which caused temporary loss of DDD pacing were observed in six patients: five had pocket infection and one had lead-dependent infective endocarditis. Conclusions: 1. Effective DDD pacing from the originally implanted system was noted selleck compound in a high percentage (72%) of patients in long-term observation (15 years). 2. Progression to permanent AF is the most common reason for loss of DDD pacing; a history of paroxysmal AF and old age are the risk factors. 3. Subclavian vein puncture is
associated with a higher rate of atrial lead damage.”
“Background: This study aims to investigate possible factors other than lymph node invasion and cell type which may affect survival in patients with lung carcinoids over long-term follow-up. Methods: This retrospective study included 82 patients (36 males, 46 females; mean age 43.8 years; range 16 to 19 years) operated with a diagnosis of bronchial carcinoid between February 1993 and November 2012. Factors that may affect survival were identified as age, sex, location of surgery, T status, N status, complete resection, resection width, cell type, and stage. Morbidities and mortalities were recorded according to these factors. Results: Mean duration of follow-up was 84 months. Ten-year survival rate was 98.5%. Of patients, 49 were T-1, 29 were T-2, and four were T-3.