Journal Article

Incidence and predictors of in-hospital events after first implantation of pacemakers

J.W.M. van Eck, N.M. van Hemel, P. Zuithof, J.P.M. van Asseldonk, T.L.H.M. Voskuil, D.E. Grobbee and K.G.M. Moons

in EP Europace

Published on behalf of European Heart Rhythm Association of the European Society of Cardiology (ESC)

Volume 9, issue 10, pages 884-889
Published in print October 2007 | ISSN: 1099-5129
Published online June 2007 | e-ISSN: 1532-2092 | DOI: http://dx.doi.org/10.1093/europace/eum113
Incidence and predictors of in-hospital events after first implantation of pacemakers

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Aims Despite an annual rise in the numbers of patients receiving their first pacemaker (PM), the risks of the implantation procedure remains unclear. The purpose of this prospective study is to estimate the incidence of in-hospital events after first PM implantation and to determine the predictors of these events.

Methods and results Patients with conventional pacing diagnosis were included in the Dutch multicentre FOLLOWPACE PM registry that prospectively documented patients' prognosis and quality of life, and PM events after first implantation. From these registry characteristics, implantation data and in-hospital findings were analysed as potential predictors for events in a sample of 1198 patients. In 111 patients studied, at least one serious in-hospital event occurred (incidence 10.1%, 95%CI: 8.9–12.3). Six variables, i.e. a lower body mass index, presence of heart failure in medical history, main indication for implantation, vena subclavia use for venous access, active atrial lead fixation, and the implantation of a dual chamber system, were found to be independent predictors of events after first PM implantation. The overall multivariable model yielded an ROC area of 0.65 (95%CI: 0.60–0.70).

Conclusion This large prospective multicentre study identified six variables as independent predictors for serious in-hospital events after first implantation. This may assist the implanting cardiologist and surgeon to identify patients at higher risk, during and immediately after PM implantation.

Keywords: Pacemaker; Pacemaker complications; Prediction; Prognosis; In-hospital events; Outcome

Journal Article.  4258 words. 

Subjects: Cardiovascular Medicine

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