Complications in dual chamber pacing: a six-year experience

In a six-year period (1980-1985), 345 dual chamber pacing systems were implanted in our hospital. Intraoperative complications were rare (n = 5/345 = 1.4%). 25 patients (7%) have died, 11 (3%) were lost to follow-up. A total of 39 patients (13%) showed minor problems, which could be overcome by reprogramming. Another 48 complications (15%) required reoperation. Nearly 70% of those reoperations (n = 31/48) were caused by a malfunction of the atrial lead. This high complication rate of 9% related to all implanted atrial leads could be reduced in the last three years to 2%. We could maintain a dual chamber stimulation mode (DDD, DDI, DVI, VDD) in 396 patients (99%). We conclude that improvements in lead design, pulse generator's programmability, and surgical experience have reduced complication rates to acceptable low values. Meanwhile, dual chamber pacing can be considered as safe as single chamber pacemaker therapy.