Permanent pacemaker insertion in a district general hospital: indications, patient characteristics, and complications
A Eltrafi, P Currie, J H Silas
Cardiovascular
Department, Wirral Hospital Trust, Upton, Wirral
Correspondence to: Dr A Eltrafi, Flat 25B, Thingwall House, Thomas Drive, Broadgreen Hospital, Liverpool L14 3LB, UK
Submitted 15 July 1999;
Accepted 8 October 1999
This report reviews the experience of permanent pacemaker
insertion in a district general hospital (catchment population of 350 000) and makes a comparison with the national database and other
hospitals in the UK.
METHODS
The records of all patients
receiving a permanent pacemaker in the inclusive period January 1996 to
December 1998 were reviewed. Data collected included number of patients
paced each year, age, sex, indications, and complications.
RESULTSIn the three years reviewed
200 patients received new permanent pacemakers, a rate of 190 per
million population per year, which is similar to the national
implantation rate of permanent pacemakers but lower than that of most
European countries (see discussion). The majority of patients paced
were elderly (75% were above the age of 70 years).
Atrioventricular block (including complete heart block, 45%, and
Mobitz type 2 block, 12.5%) was the commonest indication for permanent
pacemaker insertion, followed by sick sinus syndrome (25%) and these
findings are comparable to those reported previously. However, carotid
sinus syndrome was responsible for 16% of the patients paced and this
was higher than that reported in the national database (6.5%). Only
1% of the pacemaker modes used was inappropriate and the complication
rate was low at 3%.
CONCLUSIONSThis report confirms
that permanent pacemaker insertion can be effectively and safely
provided locally for the increasingly ageing population. The
implantation rate both locally and nationally is still much lower than
that of some countries in Europe.
Keywords: permanent pacemaker; atrioventricular block; sick sinus syndrome; carotid sinus syndrome
© 2000 by The Fellowship of Postgraduate Medicine
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