title: Late complications following permanent pacemaker implantation or elective unit replacement.
abstract: OBJECTIVE
  To determine the rate of late complications following first implantation or elective unit replacement of a permanent pacemaker system.
  
  
  METHODS
  Analysis of pacemaker data and complications prospectively acquired on a computerised database. Complications were studied over an 11 year period from January 1984 to December 1994.
  
  
  METHODS
  Tertiary referral cardiothoracic centre.
  
  
  METHODS
  Records of 2621 patients were analysed retrospectively.
  
  
  METHODS
  Complications requiring repeat procedures occurring more than six weeks after pacemaker implantation or elective unit replacement.
  
  
  RESULTS
  The overall rate of late complications was significantly lower after first implantation of a permanent pacemaker (34 cases, complication rate 1.4%, 95% confidence interval 0.9% to 1.9%) than after elective unit replacement (16 cases, complication rate 6.5% (3.3% to 9.7%). There were 20 cases of erosion, 18 infections, five electrode problems, and seven miscellaneous problems. Complications were more common with inexperienced operators (18.9% (6.0% to 31.8%)) than with experienced operators (0.9% (0.3% to 1.5%).
  
  
  CONCLUSIONS
  The incidence of late complications following pacemaker implantation is low and compares favourably with early complication rates. The majority are caused by erosion and infection. Patients who have undergone elective unit replacement are at particular risk.
authors.affiliation: Regional Cardiac Unit, Papworth Hospital NHS Trust, Cambridge, UK.
authors.forename: A A
authors.initials: AA
authors.lastname: Harcombe
authors.forename: S A
authors.initials: SA
authors.lastname: Newell
authors.forename: P F
authors.initials: PF
authors.lastname: Ludman
authors.forename: T E
authors.initials: TE
authors.lastname: Wistow
authors.forename: L D
authors.initials: LD
authors.lastname: Sharples
authors.forename: P M
authors.initials: PM
authors.lastname: Schofield
authors.forename: D L
authors.initials: DL
authors.lastname: Stone
authors.forename: L M
authors.initials: LM
authors.lastname: Shapiro
authors.forename: T
authors.initials: T
authors.lastname: Cole
authors.forename: M C
authors.initials: MC
authors.lastname: Petch
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000628:therapy; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D004868:Equipment Failure; D005260:Female; D006335:Heart Injuries / Q000209:etiology* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D013997:Time Factors; D014946:Wound Infection