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Permanent pacemaker insertion in a district general hospital: indications, patient characteristics, and complications
Insights
Permanent pacemaker insertion is safe and effective for an aging population, with implantation rates comparable to national averages but lower than in Europe. Carotid sinus syndrome is a more frequent indication locally than nationally.
Area of Science:
- Cardiology
- Medical Device Technology
- Public Health
Background:
- Permanent pacemaker insertion is a critical intervention for managing bradyarrhythmias.
- Understanding local and national pacemaker implantation trends is essential for healthcare planning.
Purpose of the Study:
- To review permanent pacemaker insertion experiences at a UK district general hospital.
- To compare local data with national databases and other UK hospitals.
Main Methods:
- Retrospective review of patient records from January 1996 to December 1998.
- Data collection included patient demographics, pacing indications, and complication rates.
Main Results:
- 200 patients received permanent pacemakers over three years (190/million/year).
- Elderly patients (75% >70 years) were the majority; atrioventricular block and sick sinus syndrome were common indications.
- Carotid sinus syndrome (16%) was a higher indication than nationally (6.5%); complication rate was 3%.
Conclusions:
- Permanent pacemaker insertion is effectively and safely provided locally for an aging population.
- UK pacemaker implantation rates remain lower than in some European countries.
Unlabelled:
This report reviews the experience of permanent pacemaker insertion in a district general hospital (catchment population of 350 000) and makes a comparison with the national database and other hospitals in the UK.
Methods:
The records of all patients receiving a permanent pacemaker in the inclusive period January 1996 to December 1998 were reviewed. Data collected included number of patients paced each year, age, sex, indications, and complications.
Results:
In the three years reviewed 200 patients received new permanent pacemakers, a rate of 190 per million population per year, which is similar to the national implantation rate of permanent pacemakers but lower than that of most European countries (see discussion). The majority of patients paced were elderly (75% were above the age of 70 years). Atrioventricular block (including complete heart block, 45%, and Mobitz type 2 block, 12.5%) was the commonest indication for permanent pacemaker insertion, followed by sick sinus syndrome (25%) and these findings are comparable to those reported previously. However, carotid sinus syndrome was responsible for 16% of the patients paced and this was higher than that reported in the national database (6.5%). Only 1% of the pacemaker modes used was inappropriate and the complication rate was low at 3%.
Conclusions:
This report confirms that permanent pacemaker insertion can be effectively and safely provided locally for the increasingly ageing population. The implantation rate both locally and nationally is still much lower than that of some countries in Europe.