Prognosis of patients permanently paced for sick sinus syndrome

In 39 patients (mean age, 66 years) treated for sick sinus syndrome (SSS) with pacemaker insertion, the long term prognosis was studied. Fifteen patients (42%) died during the follow up period of 6 to 59 months (mean, 25 months). Three patients were unavailable for follow up. Eleven of the 15 deaths (73%) were cardiac related, yet none could be associated with either an arrhythmia or pacemaker failure. Symptoms recurred or persisted after pacemaker insertion in 14 patients (mean age, 71 years), nine of whom died (31 deaths per 100 patient follow up years). Twenty two patients (mean age, 63 years) were asymptomatic after pacer insertion, six of whom died (11 deaths per 100 patient follow up years). These follow up results demonstrate a poor long term prognosis in patients with SSS and persistent symptoms following permanent pacing.