Marianne H Gillam1, Nicole L Pratt1, Maria C S Inacio1, Sepehr Shakib2, Prashanthan Sanders3, Dennis H Lau3, Elizabeth E Roughead1. 1. School of Pharmacy and Medical Sciences, The Quality Use of Medicines and Pharmacy Research Centre, University of South Australia, Adelaide, South Australia, Australia. 2. Department of Clinical Pharmacology, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia. 3. Centre for Heart Rhythm Disorders, South Australia Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, Adelaide, South Australia, Australia.
Abstract
INTRODUCTION: A large number of older people receive pacemakers each year but broad population-based studies that describe complications following pacemaker implantation in this population are lacking. METHODS: We conducted a retrospective cohort study using data from the Australian Government Department of Veterans' Affairs database. The cohort consisted of patients who received a pacemaker from 2005 to 2014. The outcomes were subsequent rehospitalizations for infections, procedure-related complications, thromboembolism, cardiovascular events (heart failure, myocardial infarction, and atrial fibrillation), and reoperation of pacemaker, and mortality. RESULTS: There were 10 883 pacemakers recipients, the median age was 86 years (interquartile range 83-89), 61% were males, and 74% received a dual-chamber pacemaker. Within 90 days postdischarge, rehospitalizations were occasioned by pacemaker infection in 0.5%, device-related complications in 1.5%, cerebral infarction in 0.7%, and heart failure in 6% of single-chamber pacemaker recipients. In dual-chamber pacemaker recipients rehospitalizations were occasioned by pacemaker infection in 0.4%, septicemia in 0.4%, device-related complications in 1.2%, cerebral infarction in 0.3%, and heart failure in 3%. Rehospitalizations for pacemaker adjustment occurred in 1.5% of patients. The 90-day postdischarge mortality was 5% and 3% in patients with single- and dual-chamber pacemaker, respectively. CONCLUSION: Rehospitalizations for infection, procedure-related complications, or thromboembolism occurred in 1% to 2% of patients within 90 days postdischarge, while 10% of single chamber and 7% of dual-chamber recipients experienced a rehospitalization for a cardiovascular event.
INTRODUCTION: A large number of older people receive pacemakers each year but broad population-based studies that describe complications following pacemaker implantation in this population are lacking. METHODS: We conducted a retrospective cohort study using data from the Australian Government Department of Veterans' Affairs database. The cohort consisted of patients who received a pacemaker from 2005 to 2014. The outcomes were subsequent rehospitalizations for infections, procedure-related complications, thromboembolism, cardiovascular events (heart failure, myocardial infarction, and atrial fibrillation), and reoperation of pacemaker, and mortality. RESULTS: There were 10 883 pacemakers recipients, the median age was 86 years (interquartile range 83-89), 61% were males, and 74% received a dual-chamber pacemaker. Within 90 days postdischarge, rehospitalizations were occasioned by pacemaker infection in 0.5%, device-related complications in 1.5%, cerebral infarction in 0.7%, and heart failure in 6% of single-chamber pacemaker recipients. In dual-chamber pacemaker recipients rehospitalizations were occasioned by pacemaker infection in 0.4%, septicemia in 0.4%, device-related complications in 1.2%, cerebral infarction in 0.3%, and heart failure in 3%. Rehospitalizations for pacemaker adjustment occurred in 1.5% of patients. The 90-day postdischarge mortality was 5% and 3% in patients with single- and dual-chamber pacemaker, respectively. CONCLUSION: Rehospitalizations for infection, procedure-related complications, or thromboembolism occurred in 1% to 2% of patients within 90 days postdischarge, while 10% of single chamber and 7% of dual-chamber recipients experienced a rehospitalization for a cardiovascular event.
Authors: S J Connolly; C R Kerr; M Gent; R S Roberts; S Yusuf; A M Gillis; M H Sami; M Talajic; A S Tang; G J Klein; C Lau; D M Newman Journal: N Engl J Med Date: 2000-05-11 Impact factor: 91.245
Authors: Kenneth A Ellenbogen; Anne S Hellkamp; Bruce L Wilkoff; Jorge L Camunãs; John C Love; Tom A Hadjis; Kerry L Lee; Gervasio A Lamas Journal: Am J Cardiol Date: 2003-09-15 Impact factor: 2.778
Authors: Erik O Udo; Nicolaas P A Zuithoff; Norbert M van Hemel; Carel C de Cock; Thijs Hendriks; Pieter A Doevendans; Karel G M Moons Journal: Heart Rhythm Date: 2011-12-17 Impact factor: 6.343
Authors: Marianne H Gillam; Nicole L Pratt; Maria C S Inacio; Sepehr Shakib; Prashanthan Sanders; Dennis H Lau; Elizabeth E Roughead Journal: Clin Cardiol Date: 2018-10-19 Impact factor: 2.882
Authors: Marianne H Gillam; Nicole L Pratt; Maria C S Inacio; Sepehr Shakib; Prashanthan Sanders; Dennis H Lau; Elizabeth E Roughead Journal: Clin Cardiol Date: 2018-10-19 Impact factor: 2.882