Early complications of permanent pacemaker implantation: no difference between dual and single chamber systems.

• DOI: 10.1136/hrt.73.6.571
• Publication Date: 2007-09-18T21:46:00Z
• Authors: R. K. Aggarwal; D. T. Connelly; S. G. Ray; J. Ball; R. G. Charles
• Keywords: Artificial cardiac pacemaker; Subclavian vein

OBJECTIVE--To evaluate the incidence of intraoperative and early postoperative complications (up to two months after implant) endocardial permanent pacemaker insertion in all patients under-going a first implant at referral centre. METHODS--Prospective evaluation implantation procedures performed from April 1992 January 1994 carried out by completion standard audit form implant. Patients9 demographic data, medical history, details hardware used, any were noted. Follow up information was also collected prospectively onto forms outpatient clinic. SETTING--United Kingdom tertiary cardiothoracic PATIENTS--1088 consecutive underwent their 1994. Implant follow data available for 1059 (97.3%) analysis. The median (range) age 77 years (16-99); 51.2 % male. RESULTS--Dual chamber units implanted 54.1% patients, single atrial 5.2%, ventricular 40.7%. A temporary pacing lead present 22.9% patients. Most (93.6%) implants via subclavian vein. Immediate rare: eight (0.8%) developed pneumothorax requiring treatment 11 (1.0%) an insignificant pneumothorax. There no significant difference rate dual (DDD) compared with systems. Arterial puncture without sequelae documented 2.7% attempts vein cannulation. total 35 (3.3%) required reoperation; reoperation (3.5%) similar that (3.1%) Electrode displacement (n = 15, 1.4%) most common reason reoperation. Atrial 10, 1.6% leads) significantly more than 5, 0.5% leads, P 0.047). electrode rates (1.6%) (1.2%) Pacemaker pocket infection led 10 (six dual, four chamber, not significant) who had place (2.9%) those did (0.4%, 0.0014). Five (0.5%) generator erosion (two three significant). further five drainage haematoma or serous fluid collection (three Complications require rare. Undersensing occurred (0.9%). undersensing 8) 2, 0.017). All successfully treated reprogramming sensitivity. Superficial wound antibiotics nine Three DDD generators sustained fibrillation: VVI mode one cardioversion. CONCLUSIONS--Permanent large centre experienced operators carries low risk. Infection are low, < 1% overall but higher undergo before implantation. Lead likely occur leads. complication pacing, however, is pacing.