![]() The dutch database FLOOWPACE PM has indexed/listed six variables associated with at least one complication prior to hospital discharge a low body mass index, history of heart failure (one of the principal indications for implantation), a subclavian venous access, an active fixation auricular pacing lead, and double lead implantation. Per-procedure mortality is extremely rare only one case was observed in the cohort of 650 patients implanted at Columbia-Presbyterian Medical Centre. Less than 5% have to incur reintervention. Their incidence is probably underestimated (approximately 7%), as is their severity ( Kiviniemi et al., 1999 Klug et al., 2003). The cardiologists’ or surgeons’ experience, and the volume of pacemakers implanted in the centre, plays a role in reducing post-implantation complications thus, guidelines discourage this procedure in centres with a low volume of implantation.ĭespite these precautions, some early complications, occurring within the first 6 weeks after implantation, may be observed. Continued education for the team and follow-up of complications is essential. This requires a centre with a qualified team of cardiologists as well as experienced nursing and technical staff. A recent trend shows pacemaker implantation can be performed as successfully in the electrophysiology study environment as in the operating room ( Garcia-Bolao & Alegria, 1999). The correct implantation of a pacemaker is capital for optimal function. ![]() Since over 10 years, left ventricular resynchronisation therapy has proved to be beneficial to patients presenting heart failure with complete left bundle block in association with optimal medical treatment the European guidelines were updated for this indication in 2010 ( Dickstein,2010) The guidelines also recommended cardiac pacing for specific conditions (vasovagal syncope, hypertrophic cardiomyopathy, heart failure with prolonged QRS duration, etc). The latest European guidelines published in 2007 confirmed the classic indications symptomatic bradyarrhythmias including sinus node dysfunction and atrioventricular or intraventricular conduction disturbances ( Vardas et al., 2007). Leads are thinner and more resistant to damage and thus equally longer-lasting. Pacemakers and implantation techniques have progressed rapidly since the then Generators are more reliable, more compact, filled with micro-electronic components, can be controlled automatically and remotely and thus providing more options for programmation and monitoring and a longer pacemaker life span ( Kusomoto & Goldschlager, 1996 Trohman, et al, 2004). A “permanent” pacemaker using epicardial electrodes was first described in 1960 ( Chardack, 1960). The first stimulations through transthoracic electrodes were pioneered by Zoll in the early fifties ( Zoll, 1952)), then came percutaneous endocardial pacing in 1959 ( Furman & Schwedel. Millions of pacemakers have been implanted worldwide and, as a result the quality of life for these patients has been drastically improved, not forgetting the reduced morbidity and mortality. The clinical benefit of cardiac pacemakers has been long proven through numerous studies.
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