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Three hundred and fifty-three consecutive patients with permanent transvenous pacemakers
Insights
Transvenous pacing is safe but electrode displacement is a common issue, especially early after implantation. This study reviews clinical experience with 353 patients to analyze pacemaker complications and outcomes.
Area of Science:
- Cardiology
- Medical Devices
- Clinical Research
Background:
- Transvenous pacing offers safety and convenience for long-term cardiac pacing.
- Electrode displacement remains a significant complication, with reported incidences ranging from 3.0% to 36.7%.
- Early post-implantation displacement rates exceeding 5% necessitate critical review, as per the Inter Society Committee on Heart Diseases (ICHD) guidelines.
Purpose of the Study:
- To evaluate clinical outcomes and complications associated with permanent transvenous pacemakers.
- To analyze the incidence and factors contributing to electrode displacement in a large patient cohort.
- To assess the overall results of transvenous pacemaker implantation over a defined period.
Main Methods:
- Retrospective analysis of 353 patients who received permanent transvenous pacemakers.
- Data collection focused on implantation procedures, complications, and patient outcomes.
- Review of clinical experience from September 1, 1974, to March 1, 1979.
Main Results:
- The study details the clinical experience with 353 patients undergoing permanent transvenous pacemaker implantation.
- Emphasis is placed on identifying and analyzing problems and complications encountered during the study period.
- Overall results concerning the efficacy and safety of the procedure are presented.
Conclusions:
- The study provides insights into the practical challenges and successes of transvenous pacemaker implantation.
- Findings underscore the importance of expertise in minimizing complications like electrode displacement.
- The clinical experience contributes to understanding long-term endocardial pacing outcomes.
Abstract:
The safety and convenience of the transvenous approach to long-term endocardial pacing are well established, but its principal drawback is electrode displacement. The reported incidence of this complication varies between 3.0% to 36.7%, and is highest in the early post-implantation period before endocardial fixation of the electrode tip. Recently Brewster and Evans determined that the electrode displacement rate in 21 published series averaged 14.3%. However, the Inter Society Committee on Heart Diseases (ICHD) report on pacemakers states that a rate of early displacement greater than 5% calls for a critical review of results. The training and expertise of the persons inserting the pacemaker electrodes undoubtedly are major factors which determine the proper transvenous placement of permanent cardiac electrodes. This paper deals with our clinical experience of 353 patients who received permanent transvenous pacemakers during the period September 1, 1974 through March 1, 1979, with emphasis on problems and complications encountered and overall results.