Hospital Procedure Volume and Complications in Pacemaker Implantation

Hospitals with lower pacemaker implantation volume are associated with a significantly higher rate of surgical complications and lead dislocations both male and female patients, though implantation rates of complex systems are lower, according to a new study presented Aug. 30 as part of ESC Congress 2014. Further, surgical complications and ventricular lead dislocations occur more frequently in women, while men experience more atrial lead dislocations.

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Since previous studies have demonstrated a relationship between hospital implantable cardioverter defibrillator (ICD) implantation volume and complication rates, but have yet to demonstrate whether such a relation existed for pacemaker therapy, the new investigation was led by Bernd Nowak, MD, Cardioangiologisches Centrum Bethanien, Frankfurt, Germany, who retrospectively assessed the country's obligatory external quality control program for the year 2007-2012.

Results showed that overall, 430,416 in-hospital implantations were performed in 1,226 hospitals, with a mean age of 75.9 ± 10.5 years (53.4 percent male). With implanted systems divided between dual-chamber pacemakers (73.5 percent), single-chamber pacemakers (26.1 percent), and CRT-pacemaker systems (1.1 percent), the total in-hospital complication rate was 0.99 percent for surgical complications, 0.92 percent for ventricular lead dislocation, and 1.22 percent for atrial lead dislocation.

Keywords: Quality Control, Pacemaker, Artificial, Defibrillators, Implantable

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