Characteristics, indications and complications in patients undergoing permanent pacemaker implantation: a single centre study
DOI:
https://doi.org/10.18203/2320-6012.ijrms20184906Keywords:
Atrioventricular block, Left bundle branch block, Pacemaker, Pneumothorax, Sepsis, Sinus node diseaseAbstract
Background: To determine the demographic details, indications, type of pacemakers and complications in patients undergoing the permanent pacemaker implantation.
Methods: This was a single-center, retrospective study conducted in at a tertiary-care center in India. The records of 200 patients who had undergone implantation of permanent pacemakers in the period of May 2016 to April 2018 were reviewed.
Results: Total 200 patients with mean age of 67 years were paced. Of these 120 (60%) were males. The mean duration of hospital stay was 6.5 days. Sinus node disease (105 patients, 52.5%) was the most common indication for permanent pacemaker insertion. Single chamber (VVIR) pacing mode (125 patients, 62.5%) was found to be the most common pacing mode used for pacemaker insertion. Among the 200 patients complications were observed in 8 patients (4%). Of these 8 patients, pneumothorax (4 patients, 2%) was found to be the most common complication for permanent pacemaker implantation followed by local site infection (1 patient, 0.5%). Only 1 patient (0.5%) died during the observation period of the study.
Conclusions: Geriatric population with male predominance have observed to commonly undergo permanent pacemaker implantation. Sinus node disease in the elderly patients is the most common indication for cardiac pacing followed by atrioventricular block. Single chamber (VVIR) pacing mode is commonly used followed by dual chamber (DDDR) due to economic reasons in India. Pacemaker implantation is a relatively safe procedure with a low complication rate.
References
Kotsakou M, Kioumis I, Lazaridis G, Pitsiou G, Lampaki S, Papaiwannou A, et al. Pacemaker insertion. Annals of translational Medicine. 2015;3.
Batra AS, Balaji S. Post operative temporary epicardial pacing: When, how and why? Annals of Pediatric Cardiol. 2008;1:120.
Zhan C, Baine WB, Sedrakyan A, Steiner C. Cardiac device implantation in the United States from 1997 through 2004: a population-based analysis. J Gen Inter Med. 2008;23:13-19.
Branch-Elliman W, Stanislawski M, Strymish J, Barón AE, Gupta K, Varosy PD, et al. Cardiac electrophysiology laboratories: a potential target for antimicrobial stewardship and quality improvement? infection control and hospital epidemiology. 2016;37:1005-11.
Uslan DZ, Tleyjeh IM, Baddour LM, Friedman PA, Jenkins SM, St Sauver JL, et al. Temporal trends in permanent pacemaker implantation: a population-based study. American Heart J. 2008;155:896-903.
Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR, Committee HICPA. Guideline for prevention of surgical site infection, 1999. infection control and hospital Epidemiology. 1999;20:247-80.
Khanal J, Poudyal R, Devkota S, Thapa S, Dhungana R. Clinical profile and early complications after single and dual chamber permanent pacemaker implantation at Manmohan cardiothoracic vascular and transplant centre, Kathmandu, Nepal. J Nepal Health Res Council. 2015;13:138-43.
Aggarwal RK, Connelly DT, Ray SG, Ball J, Charles RG. Early complications of permanent pacemaker implantation: no difference between dual and single chamber systems. Heart. 1995;73:571-75.
Eltrafi A, Currie P, Silas J. Permanent pacemaker insertion in a district general hospital: indications, patient characteristics, and complications. Postgraduate Medical J. 2000;76:337-39.
Shenthar J, Bohra S, Jetley V, Vora A, Lokhandwala Y, Nabar A, et al. A survey of cardiac implantable electronic device implantation in India: By Indian Society of Electrocardiology and Indian Heart Rhythm Society. Indian Heart J. 2016;68:68-71.
Baddour LM, Epstein AE, Erickson CC, Knight BP, Levison ME, Lockhart PB, et al. Update on cardiovascular implantable electronic device infections and their management: a scientific statement from the American Heart Association. Circulation. 2010;121:458-77.
Vardas PE, Auricchio A, Blanc J-J, Daubert J-C, Drexler H, Ector H, et al. Guidelines for cardiac pacing and cardiac resynchronization therapy: the task force for cardiac pacing and cardiac resynchronization therapy of the European Society of Cardiology. Developed in collaboration with the European Heart Rhythm Association. European Heart J. 2007;28:2256-95.
Trohman RG, Kim MH, Pinski SL. Cardiac pacing: the state of the art. The Lancet. 2004;364:1701-19.
Stevenson RT, Lugg D, Gray R, Hollis D, Stoner M, Williams JL. Pacemaker implantation in the extreme elderly. J Interventional Cardiac Electrophysiology. 2012;33:51-58.
Res J, de Priester J, van Lier A, van Engelen C, Bronzwaer P, Tan P, et al. Pneumothorax resulting from subclavian puncture: a complication of permanent pacemaker lead implantation. Netherlands Heart J. 2004;12:101.
Pavia S, Wilkoff B. The management of surgical complications of pacemaker and implantable cardioverter-defibrillators. Current opinion in Cardiol. 2001;16:66-71.
Parsonnet V, Bernstein AD, Lindsay B. Pacemaker-implantation complication rates: an analysis of some contributing factors. J American College Cardiol. 1989;13:917-21.
Ellenbogen KA, Hellkamp AS, Wilkoff BL, Camunãs JL, Love JC, Hadjis TA, et al. Complications arising after implantation of DDD pacemakers: the MOST experience. The American J Cardiol. 2003;92:740-41.
Kaushik V, Leon AR, Forrester JS, Trohman RG. Bradyarrhythmias, temporary and permanent pacing. Critical Care Medicine. 2000;28:N121-N28.
Müller C, Cernin J, Glogar D, Laczkovics A, Mayr H, Scheibelhofer W, et al. Survival rate and causes of death in patients with pacemakers: dependence on symptoms leading to pacemaker implantation. European Heart J. 1988;9:1003-09.
Kusumoto FM, Goldschlager N. Cardiac pacing. New England J Med. 1996;334:89-99.
Tveskov C, Skytthe A, Arnsbo P, Vaupel JW, Møller M, Christensen K. Twins with implanted pacemakers: Is there an increased mortality risk for the co-twin? A follow-up study based on the Danish Twin Registry and the Danish Pacemaker Register. EP Euro. 2005;7:598-603.
Harrigan RA, Chan TC, Moonblatt S, Vilke GM, Ufberg JW. Temporary transvenous pacemaker placement in the emergency department. J Emergency Med. 2007;32:105-11.
Mond HG, Proclemer A. The 11th world survey of cardiac pacing and implantable cardioverter‐defibrillators: calendar year 2009-a World Society of Arrhythmia's project. Pacing Clin Electrophysiol. 2011;34:1013-27.
Andersen HR, Thuesen L, Bagger JP, Vesterlund T, Thomsen PEB. Prospective randomised trial of atrial versus ventricular pacing in sick-sinus syndrome. The Lancet. 1994;344:1523-28.
Andersen HR, Nielsen JC, Thomsen PEB, Thuesen L, Mortensen PT, Vesterlund T, et al. Long-term follow-up of patients from a randomised trial of atrial versus ventricular pacing for sick-sinus syndrome. The Lancet. 1997;350:1210-16.
Bernstein AD, Parsonnet V. Survey of cardiac pacing in the United States in 1989. Ame J Cardiol. 1992;69:331-38.
Belott PH. A variation on the introducer technique for unlimited access to the subclavian vein. Pacing and Clinical Electrophysiology. 1981;4:43-7.
