Complications of Permanent Transvenous Cardiac Pacing: A 14‐Year Review of all Transvenous Pacemakers Inserted at One Community Hospital
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Five hundred and eighty‐nine consecutive transvenous pacemakers implanted between January 1, 1971 and January 1, 1985 were reviewed. A complication incidence of 17% early in the study period (1971–1977) was caused by electrode displacement and perforation. As of 1975, smaller‐sized electrodes with endocardial fixation were used and were associated with a significant decrease in this complication incidence to 2% by 1985. All other complications occurring during the entire study period (1971–1985) occurred at a frequency of 3% (20/589). Infection occurred in 3 of 589 cases; there were no extrusions or erosions. No mortality was attributed to pacemaker insertion. The “twiddler” syndrome seems to be increasing in frequency. Transvenous permanent pacing can be accomplished today with a low complication rate of 5% or less. The majority of these complications are minor and can be corrected easily. Our studies suggest that the reduced complication incidence is mainly related to improved technology.Keywords:
Transvenous pacing
Cardiac Pacing
Perforation
Permanent pacemaker
The incidence and prevalence of peptic ulcer disease has decreased in recent years, but it is not so easy to make the same conclusion when complications of peptic ulcer are taken into consideration. The aim of this study is to determine the time trends in complicated peptic ulcer disease and to state the effects of H2 receptor blockers, proton pump inhibitors (PPI), and H. pylori eradication therapies on these complications.This study retrospectively evaluated the patients who were operated on for complications (perforation, bleeding, and obstruction) of peptic ulcer for the last 50 years. Patients were grouped into four groups (G1-G4) according to the dates in which H2 receptor blockers, PPIs, and eradication regimens for H. pylori were introduced The time periods that were studied were: (G1) 1962-1980, (G2) 1981-1990, (G3) 1991-1997, and (G4) 1998-2012.In total, 2953 patients were operated on for complications of peptic ulcer disease, of which 86% of the patients were male. In G1, perforation and obstruction were significantly the most frequent complications (p<0.001), followed by bleeding. In groups G2 and G3, obstruction was still the most frequent complication requiring surgery (p<0.001). In G2 and G3, obstruction was followed by perforation and bleeding, respectively. In G4, perforation was significantly the most frequent complication (p<0.001).From 1962 to 1990 obstruction was the most common complication requiring surgery. In the last decade, perforation became the most common complication. In contrast to reports in the literature, bleeding was the least common complication requiring surgery in Turkey.
Perforation
Peptic
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Five hundred and eighty‐nine consecutive transvenous pacemakers implanted between January 1, 1971 and January 1, 1985 were reviewed. A complication incidence of 17% early in the study period (1971–1977) was caused by electrode displacement and perforation. As of 1975, smaller‐sized electrodes with endocardial fixation were used and were associated with a significant decrease in this complication incidence to 2% by 1985. All other complications occurring during the entire study period (1971–1985) occurred at a frequency of 3% (20/589). Infection occurred in 3 of 589 cases; there were no extrusions or erosions. No mortality was attributed to pacemaker insertion. The “twiddler” syndrome seems to be increasing in frequency. Transvenous permanent pacing can be accomplished today with a low complication rate of 5% or less. The majority of these complications are minor and can be corrected easily. Our studies suggest that the reduced complication incidence is mainly related to improved technology.
Transvenous pacing
Cardiac Pacing
Perforation
Permanent pacemaker
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Perforation
Pathogenesis
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Abstract Summary: A case of progressive venous thrombosis involving the superior vena cava is reported following implantation of a permanent transvenous pacemaker. Acute symptoms in the arm appeared after 18 months, but the symptoms of superior vena caval obstruction developed gradually, three years after pacemaker insertion. The diagnosis was confirmed by cavography and symptoms resolved with heparin therapy. Long‐term anticoagulation is indicated when thrombosis is responsible for this uncommon but important complication of transvenous pacing.
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Objective To clarify the experience of peri-operation complication, their prevention and treat-ment in permanent eardic pacemaker implantation. Methods Retrospective analysis of 52 patients with permanent eardic pacemaker implantation, 6 patients occurred peri-operation complications(11.5 %), including 1 patient with cardic arrest and 1 patient with ventricular fibrillation in operation, 1 patient with hamothorax and 1 patient with electrode move after operation,2 patients with bag haematoma. Results All the complication were correctly cured.Conclusion The three key ways to prevent and treat complication contain adequant preparation before operation,skillful technique in operation and active managment within peri-operation.
Key words:
Pacemaker, artificial; Intraoperative; Complication
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Peri
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Transvenous pacing
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The finding of complete occlusion of the superior venal cava during the performance of cardiac pacing is rare. We report a case where performance of angioplasty aided the successful completion of permanent pacemaker implantation.
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Transvenous pacing
Permanent pacemaker
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Aim To promote the experience of peri-operation complication and treatment in permanent cardiac pacemaker implantation.Methods Retrospective analysis of 99 patients with permanent cardiac pacemaker implantation during January 2004 to October 2008,analysis the causes,the treatment and the results of peri-operational complication.Results All operations are successful,and the ratio of peri-operational complication was 11.11%.5(5.05%)patients with bag haematoma,including 1 patient was transferred,2 patients' haematoma were absorbed after compression wrap,and the other 2 patients' haematoma were absorbed by disinfection and wrap.The electrode dislocation induced pacemaker dysfunction occurred in 2 patients and reversed by reposition.The actuator anchor screw becomes less crowded in 2 patients and corrected by re-operation.Conclusions The main Influence to curative effect of cardiac pacemaker is complication after implantation.Adequate preparation to prevention,skillful technique in operation and follow-up visit positively is necessary to decreasing the complication,and increasing treatment benefit.
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The establishment of a local permanent pacemaker service in a district general hospital increased the pacemaker implantation rate from 22 per million population per year to 152 per million population per year over the first 6 years of the service. Forty eight per cent of patients were referred by general practitioners and 52% by hospital specialists. Single chamber demand pacing (VVI) was used exclusively. Indications for pacing and complications were comparable to those of specialist cardiac centres. Management of symptomatic bradycardia by cardiac pacing in the United Kingdom may be facilitated by further development of small pacing centres.
Cardiac Pacing
Permanent pacemaker
Transvenous pacing
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Atrioventricular block
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Cardiac Pacing
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Permanent pacemaker
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