A Decade of Nuclear Pacing

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Abstract
In April, 1973, a decade‐long study was begun on nuclear‐powered pacemakers. The first 15 of these were designed by the Numec Corporation under a contract from the United States Atomic Energy Commission. Altogether 151 units powered by the isotope Plutonium 238 were implanted in 131 patients; the pacemakers of 4 different manufacturers were used. The last nuclear pacemaker was implanted in January, 1983. The actuarial survival at 10 years was 92%, meeting the original performance goal of the Commission of 90%. Ninety pulse generators are still in service today; 25 patients have died and 36 pulse generators have been replaced with non‐nuclear units. The most common indication for replacement was an inappropriate pacing mode. This high reliability and superior performance suggest that continued use of a radioisotopic power source is justified, particularly if combined with the electronic circuits of today's dual‐chambered, multiprogrammable, and multifunctional pacemakers.

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