Probleme, Komplikationen und Notfälle bei der Schrittmacherimplantation

Abstract

Pacemaker implantation represents a standard procedure with a perceived 100% success rate, without mortality and with extremely rare complications. However, some pacemaker implantations may develop into a very difficult procedure or even be associated with significant complications. Good venous access is crucial and may distinguish between comfortable, successful implantation and futile implantation with severe complications (e.g., pneumo- or hematothorax, venous dissection or perforation, accidental arterial implantation, or air embolism). This review summarizes acute problems and complications during lead implantation and provides tips and hints for prevention and acute reaction during implantation. If these simple precautions are considered, the majority of acute complications during implantation of pacemaker leads can be prevented.

Influence of implantation access on complication rates in pacemaker implantation: An analysis of quality insurance data

“…The mortality rates reported in previous studies range between 0.1% and 1.3% and the determined intra-hospital mortality (1.4%) rate is comparable to previous studies [6,8,14,17]. We recorded intra-hospital mortality at time of discharge from the hospital.…”

“…Furthermore, we found that after risk adjustment, VS access is associated with a signi icant higher risk for asystole and pneumothorax. The higher risk for the development of pneumothorax after subclavian puncture is suf iciently known and is described in many studies without further investigation of possible reasons [5][6][7]20]. Within the study population, 90% of the observed pneumothoraces occurred after subclavian puncture.…”

“…In Germany, more implantations are performed via VS than via VC [2]. Reasons are the reported higher success rate, the shorter operation and luoroscopy times, lower blood loss and the simple puncture of the vein [3][4][5][6][7]. Additionally, the access via VS is associated with a higher rate of pneumothorax [6,7].…”

Inflammatory Pericardial Pseudocyst Secondary to Atrial Myocardial Perforation: A Rare Complication following Transvenous Pacemaker Implantation

“…Pacemaker insertion is a safe procedure with a 3% incidence of major complications, including perforation of heart chambers with or without tamponade, pneumothorax, hemothorax, and air embolism [ 4 ]. In the present case, diagnosis of early postpacemaker implantation pericarditis was established by clinical presentation, laboratory data, and echocardiography.…”