No abstract

Background and objectives: Argument has been made to eliminate implantation of permanent pacemakers by cardiac surgeons on the basis that surgeons have not kept up with technologic advances in pacing. This study examined two eras of pacing therapy in a hospital where pacemaker implantation had always been performed by cardiac surgeons but this practice changed rapidly during the year 2000 when an established pacemaker service was set up by a group of cardiologists.Methods: We compared all available data from all pacemakers implantations during the first half of the year 1999 (surgical era, era 1) with the first half of the year 2001 (cardiologist era, era 2).Results: A total 114 pacemakers had been implanted during the era 1 (46.5% male, mean age 63.3 ± 18.4) and 299 cases during the era 2 (63.9% male, mean age 63.9 ± 18.2). Indications for implantation were nearly similar with AV block as the most common one in 77% and 75% during eras 1 and 2 respectively. Single chamber pacemakers comprised 86% of implants during era 1 compared to 54% during era 2 (P < 0.01). The median duration of admission was 18 days during era 1 and 10 days during era 2. Pacemaker malfunctions were detected following 7.9% of implantations during era 1 compared to 0.3% during the era 2 (P < 0.01). Re-do procedures were performed after 2.7% of implantations during era 1 compared to 0.3% during era 2 (P < 0.01).Conclusions: Pacemaker implantation is better performed by a coordinated pacemaker service run by cardiologist trained in pacemaker implantation.