Incidence and predictors of in-hospital events after first implantation of pacemakers.
OBJECTIVE
Despite an annual rise in the numbers of patients receiving their first pacemaker (PM), the risks of the implantation procedure remains unclear. The purpose of this prospective study is to estimate the incidence of in-hospital events after first PM implantation and to determine the predictors of these events.


RESULTS
Patients with conventional pacing diagnosis were included in the Dutch multicentre FOLLOWPACE PM registry that prospectively documented patients' prognosis and quality of life, and PM events after first implantation. From these registry characteristics, implantation data and in-hospital findings were analysed as potential predictors for events in a sample of 1198 patients. In 111 patients studied, at least one serious in-hospital event occurred (incidence 10.1%, 95%CI: 8.9-12.3). Six variables, i.e. a lower body mass index, presence of heart failure in medical history, main indication for implantation, vena subclavia use for venous access, active atrial lead fixation, and the implantation of a dual chamber system, were found to be independent predictors of events after first PM implantation. The overall multivariable model yielded an ROC area of 0.65 (95%CI: 0.60-0.70).


CONCLUSIONS
This large prospective multicentre study identified six variables as independent predictors for serious in-hospital events after first implantation. This may assist the implanting cardiologist and surgeon to identify patients at higher risk, during and immediately after PM implantation.
van Eck
J W M
JW
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Bolognalaan 12, 3584 CJ Utrecht, The Netherlands. j.w.m.vaneck-2@umcutrecht.nl
van Hemel
N M
NM
Zuithof
P
P
van Asseldonk
J P M
JP
Voskuil
T L H M
TL
Grobbee
D E
DE
Moons
K G M
KG
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002304:Cardiac Pacing, Artificial; D005260:Female; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010138:Pacemaker, Artificial; D011183:Postoperative Complications / Q000209:etiology*; D011446:Prospective Studies; D011788:Quality of Life; D016896:Treatment Outcome