Transvenous Cardiac Pacing: 12-year Experience in Lagos, Nigeria

The advent of cardiac pacemaker insertion has revolutionised the treatment of symptomatic bradycardia. As is often the case with low- and middle-income countries (LMICs), the entry of new technology, pacemakers included, lagged-behind those of their high-income counterparts. Access to pacemaker devices and the required expertise in LMICs has, however, increased over the last decade.

The aim is to review the outcome of pacemaker implantation in our city, increase awareness and advocate for an upgrade of the current standard.

A retrospective review of patients who had permanent pacemaker insertion (PPI) for symptomatic bradycardia records in three centres over 12 years spanning from January 2011 to December 2022. Data on patients' demographics, clinical presentation, indications for pacemaker insertion and treatment outcomes were extracted. The data were analysed using the SPSS version 24 software.

A total of 133 patients (68 males, 67 females) had PPI at three hospitals during the study period. Their age range was 26-99 years, with median and mean ages of 70 and 67.72 ± 13.97 years, respectively. There was equal gender distribution. The mean pulse rate at presentation was 38.70 ± 6.56 per minute. The most frequent indication for PPI was complete heart block ( n = 117, 88%). Single-chamber pacemaker (VVIR) was inserted in 95.5%. Acute lead dislodgement was the most frequent complication.

PPI has revolutionised the treatment of symptomatic bradycardia, contributing to increased life expectancy. Upgrading and increased affordability will benefit more patients with indications for PPI, and extend life expectancy.