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Permanent Pacemaker Implantation After Minimally Invasive Robotic Cardiac Surgery and Long-Term Pacemaker Dependence

Özkan Eravcı1, Salim Yaşar1, Hatice Taşkan2

  • 1Department of Cardiology, Gülhane Training and Research Hospital, University of Health Sciences, Ankara, Türkiye.

Anatolian Journal of Cardiology
|June 12, 2026
PubMed
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This summary is machine-generated.

Minimally invasive robotic heart surgery is growing, but longer bypass times and combined valve procedures increase the need for permanent pacemakers (PPMs). Patients requiring PPMs experienced significant long-term pacing needs.

Area of Science:

  • Cardiovascular Surgery
  • Minimally Invasive Surgery
  • Robotic Surgery

Background:

  • Minimally invasive robotic heart surgery is expanding due to technological advances and proven safety.
  • Its role in cardiac procedures is increasingly recognized.
  • This study evaluates permanent pacemaker (PPM) implantation in this surgical context.

Purpose of the Study:

  • To assess PPM implantation rates after robotic heart surgery.
  • To identify perioperative factors influencing PPM need.
  • To analyze long-term pacing requirements in these patients.

Main Methods:

  • Retrospective analysis of 276 patients undergoing robotic heart surgery.
  • Comparison of patients with and without post-operative PPM implantation.

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  • Analysis of demographic data, comorbidities, and intraoperative variables.

    • Main Results:

    • Permanent pacemakers were implanted in 5.4% of patients.
    • Longer cardiopulmonary bypass (CPB) times were associated with higher PPM rates (median 210 vs. 150 minutes).
    • Concurrent mitral-tricuspid valve surgery significantly increased PPM implantation risk (40.0% vs. 10.3%).

    Conclusions:

    • Prolonged CPB duration is a risk factor for PPM implantation in robotic cardiac surgery.
    • Combined mitral-tricuspid valve procedures elevate the likelihood of needing a pacemaker.
    • Patients receiving pacemakers showed a significant long-term pacing burden post-surgery.