Early outcome of permanent pacemaker implantation

Abstract

Background: Permanent pacemaker implantation (PPI) is considered the most effective and safe procedure for treatment of symptomatic bradyarrythmia. In this study we evaluated incidence of intraoperative and early postoperative (three month) outcome of PPI in our center.
 Method: This is a cross sectional study carried out over a period twenty months between Jan 2017 and August 2018. All patients undergoing PPI at Nobel Medical College were enrolled in the study. Details of demographic data, medical history, hardware used and complications were recorded. Prospective follow up was done in outpatient department upto three months.
 Result: A total of seventy-six patients were enrolled in the study. Fifty-one (67%) were male and twenty-five (33%) were female. Ninety percent of the patient was above the age of sixty-five years. Fifty-five (71%) received single chamber and twenty-one (28%) received dual chamber pacemaker. Majority of the patient (87%) had a diagnosis of complete heart block. There was no mortality unto 3 months. Majority (92%) of the patient had no complications at all. Two patients had pocket site infection. Lead dislodgment was noted in three patients. Lead perforation and acute temponade occurred during intraoperative period in one case, which was successfully managed by pericardiocentesis.
 Conclusion: In summary permanent pacemaker implantation was effective and relatively safe procedure in our center with no mortality.

Study of clinical profile and indications of Permanent Pacemaker Insertion in Nepali population presenting to tertiary care centre in Nepal

“…The most common indication for PPI was CHB followed by SSS. Similar findings were noted in study done by Khanal J et al 9 and Jha S et al 11 whereas study done by Monib A et al 10 showed much higher incidence of CHB (87%) than our study. Annual report of SGNHC showed 65-78% incidence of CHB but much lesser incidence of SSS (6-9%) compared to our study 13 .…”

“…Only 13 women (11.6%) received dual chamber pacemaker compared with 36 men (21.8%) (P = 0.029). Other studies published in Nepal also show similar incidence of single chamber pacemakers over dual chamber ones 9,10,13 . The finding of the study done in Australia is different with our study, which revealed that 74% of the patients received a dual chamber pacemaker 14 .…”

“…Our study shows that among patients receiving PPI, 165 (59.5%) were male and 112 (40.5%) were female with male to female ratio of 1.47. Studies published in Nepal by Khanal J et al 9 , Monib A et al 10 and Jha S et al 11 showed similar age distribution with male predominance in PPI. Male predominance in PPI was also shown in annual report published by SGNHC 13 .…”

“…Nepal for the last 20 years, there is no large scale published data of pacemaker implantations. Few studies and reports have been published regarding clinical profile, short term outcome, experiences and gender differences in pacemaker implantation in different centre including MCVTC[9][10][11][12][13] .The objective of this study is to analyze the clinical profile and indications of permanent pacing in Nepali population presenting to Age Distribution of Patients with PPI…”

Trends and Profile of Permanent Pacemaker Implantation in Nepal. Experience From Tertiary Cardiac Center (SGNHC) From 2001 to 2020.

“…2 There are few studies and reports have been published regarding clinical profile, short term outcome, experiences in pacemaker implantation in different center in our part of the world. [3][4][5][6][7] This study intended focusing on permanent pacemaker implantation (PPI) of 19 years data at the referral tertiary cardiac center which will highlight and reflect a clear picture of the trends and profile of PPI implantation in Nepal.…”