Czy możliwe jest bezpieczne skrócenie czasu hospitalizacji pacjentów po zabiegu implantacji stymulatora dwujamowego serca w ośrodku wysoko specjalistycznym? Can we discharge patients from a reference center 24 hours after dual chamber pacemaker implantation?

Background: The cost of a pacemaker (PM) system increases with its degree of complexity and sophistication. We are forced to reduce the costs of the treatment of our patients. One of the method which can lead to this, is to shorten the duration of hospitalization in cardiological refernce center. Although marked development of PM and lead technology in the last years was achieved still, the potential risk for pacemaker implanted patient must be considered. That is why we decide to estimate the safety of pacemaker implantation in patients with 24 hour hospitalization. The aim of the study was to assess the safety of 24 hour hospitalization in reference center after dual chamber PM (DDD PM) implantation. Material and methods: Prospective analyze of 80 patients with DDD PM was performed. Patients were devided into two groups: group I — 42 patients with long term hospitalisation in reference center (RC), group II — 38 patients with 24 hour hospitalisation in RC. Following electrical and clinical parameters were compared between two groups on the 1 st day (1 dFU) and 3 months (3 mFU) after implantation: atrial and ventricle pacing threshold, P and R wave amplitude, lead impedance, lead dislodgment, pocket haematoma, pneumothorax. Additionally Holter recordings in all patients in 1 dFU and 3 mFU was performed to estimate: all PM disturbances (PD), failure to pace (FP), failure to sense (FS). Failure to sense were divided to over (FSO) and undersensing (FSU) episodes. Results: All electrical parameters during 1 dFU and 3 mFU were satisfactory and there were no significant differences between two groups. There was any incidence of lead dislodgment, pocket haematoma, pneumothorax noted within 24 hours after implantaion and at 3 months FU.