[Use of the electric stimulation of the heart in sick sinus syndrome (achievements and disputable problems)].

Experience with cardiac electrostimulation for the weak sinus node syndrome is presented. Between 1982 and 1985, 296 primary pacemaker implantations were performed, or 21.44% of all primary implantations performed over that period. The weak sinus node syndrome was diagnosed on the basis of ECG, Holter's monitoring and the atrial stimulation test. Initial atrioventricular conductivity disorders were recorded in 22.1%. Atrioventricular conductivity deteriorated in 16.1% of patients after 2 to 8 years of follow-up. The right ventricle was the principal stimulus application site in 267 patients, right-atrial stimulation was performed in 9, and double stimulation (radio-frequency right-atrial stimulation plus right-ventricular or right-atrial stimulation on demand), in 20. Permanent atrial fibrillation developed in 25% of 144 patients, followed up for 2 to 8 years, and the implant was removed in 5 (14%) patients.