Related Experiment Video
Updated: Nov 6, 2025
Sterile Pericarditis in Aachener Minipigs As a Model for Atrial Myopathy and Atrial Fibrillation
Published on: September 24, 2021
Impact of early (<7 days) pacemaker implantation after cardiac surgery on long-term pacemaker dependency
Marc Badoz1,2, Baptiste Favoulet1, Guillaume Serzian1
1Department of Cardiology, University Hospital Besançon, Boulevard Fleming, Besançon, France.
Insights
Early pacemaker implantation after cardiac surgery does not affect long-term dependency. However, early pacemaker placement is linked to shorter hospital stays and reduced new-onset atrial fibrillation (AF).
Area of Science:
- Cardiology
- Cardiac Surgery
- Electrophysiology
Background:
- Pacemaker implantation is sometimes necessary after cardiac surgery.
- The timing of pacemaker implantation (early vs. late) may influence patient outcomes.
- Understanding long-term pacemaker dependency is crucial for patient management.
Purpose of the Study:
- To compare long-term pacemaker dependency in patients receiving early (<7 days) versus late (≥7 days) pacemaker implantation after cardiac surgery.
- To evaluate secondary endpoints including length of hospital stay and in-hospital complications.
Main Methods:
- Retrospective analysis of 108 patients who underwent pacemaker implantation post-cardiac surgery.
- Patients were categorized into early (<7 days) and late (≥7 days) implantation groups.
- Pacemaker dependency was assessed at a median follow-up of 3.2 years using logistic regression to identify predictors.
Main Results:
- No significant difference in long-term pacemaker dependency was observed between early and late implantation groups (66.7% vs. 46.5%, p=0.15).
- Patients with early implantation had a significantly shorter length of hospital stay (11.5 vs. 15.0 days, p=0.002).
- Early implantation was associated with a lower incidence of new-onset atrial fibrillation (AF) post-surgery (22.7% vs. 47.8%, p=0.05).
Conclusions:
- Early pacemaker implantation (<7 days) after cardiac surgery does not increase long-term pacemaker dependency.
- Early implantation is associated with benefits such as shorter hospital stays and reduced new-onset AF.
- Further prospective studies, including randomized trials, are recommended to confirm these findings.
Objective:
We aimed to investigate pacemaker dependency after at least 1 year in patients with early (<7 days) implantation, compared to those who received a pacemaker ≥7 days after cardiac surgery. Secondary endpoints were length of hospital stay and in-hospital complications.
Methods:
Retrospective analysis of 108 consecutive patients who received a pacemaker after cardiac surgery between 06/2012 and 06/2018. Characteristics and outcomes were compared between patients with early (<7 days) and late (≥7 days) implantation. Patients were followed up with evaluation of pacemaker dependency between April and June 2019. We identified predictors of dependency by logistic regression.
Results:
In total, 63.9% were men, average age 71.9 ± 11.8 years; 32 (29.6%) had early implantation, and 76 (70.4%) late implantation. After a median 3.2 years [IQR 1.9, 4.5] of follow-up, 30 patients (27.8%) had died, and there was no difference in pacemaker dependency among survivors (66.7% vs. 46.5%, early vs. late respectively, p = .15). Patients in the early group had a shorter length of stay (11.5 [9.0, 14.0] vs. 15.0 [11.5, 20] days, p = .002) and less often had new-onset atrial fibrillation (AF) post-surgery (22.7% vs. 47.8%, p = .05). The only significant predictor of dependency was aortic valve replacement surgery (OR = 4.70, 95% CI [1.36 to 16.24]).
Conclusion:
Early implantation of a permanent pacemaker (<7 days after cardiac surgery) does not impact on the proportion of patients with long-term (>12 months) pacemaker dependency, but is associated with shorter length of stay and less frequent new-onset AF. These findings warrant prospective confirmation in randomized trials.
Related Concept Videos
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
01:29Cardiomyopathy V: Interprofessional Care
01:30Pulse rhythm
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...