Short-term implantation-related complications of cardiac rhythm management device therapy: a retrospective single-centre 1-year survey.
OBJECTIVE
The aim of this study was to evaluate the current short-term (<3 months) complication rate related to cardiac rhythm management (CRM) device implantations.


RESULTS
We analysed data of the complications related to all CRM device implantations during 1 year (2006) in a tertiary referral university hospital. In 567 device implantations, pacing system upgrade procedures, or lead revisions, 78 complications occurred in 69 (12.2%) patients. Lead dislodgement, pocket haematoma or bleeding, pneumothorax, and infection were the most common accounting for >80% of all complications. The complication rate was more than twice as high in bradycardia pacemaker (PM) implantations performed by cardiology trainees (17.4%) than by experienced cardiologists (7.7%, P = 0.001). When performed by experienced cardiologists, the complication rate was not higher in implantations of more complex devices compared with that of bradycardia PMs. Fifty-two of the 69 patients needed additional surgical procedures. Altogether, the complications required 504 additional treatment days in hospital.


CONCLUSIONS
In conclusion, our retrospective 1-year single-centre survey shows that short-term implantation-related complications of contemporary device therapy are still frequent, occur much more frequently by trainees than by cardiologists, require a large number of additional surgical procedures, and substantially prolong the hospital stay.
Pakarinen
Sami
S
Department of Cardiology, Helsinki University Central Hospital, Haartmaninkatu 4, PO Box 340, 00029 HUS Helsinki, Finland. sami.pakarinen@hus.fi
Oikarinen
Lasse
L
Toivonen
Lauri
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D004554:Electric Countershock / Q000706:statistics & numerical data*; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial / Q000706:statistics & numerical data*; D011361:Professional Competence / Q000706:statistics & numerical data*; D016459:Prosthesis-Related Infections / Q000453:epidemiology*; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult