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Kotsakou M, Kioumis I, Lazaridis G, Pitsiou G, Lampaki S, Papaiwannou A, Karavergou A, Tsakiridis K, Katsikogiannis N, Karapantzos I, Karapantzou C, Baka S, Mpoukovinas I, Karavasilis V, Rapti A, Trakada G, Zissimopoulos A, Zarogoulidis K, Zarogoulidis P. Pacemaker insertion. ANNALS OF TRANSLATIONAL MEDICINE 2015; 3:42. [PMID: 25815303 DOI: 10.3978/j.issn.2305-5839.2015.02.06] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 01/28/2015] [Indexed: 01/13/2023]
Abstract
A pacemaker (PM) (or artificial PM, so as not to be confused with the heart's natural PM) is a medical device that uses electrical impulses, delivered by electrodes contracting the heart muscles, to regulate the beating of the heart. The primary purpose of this device is to maintain an adequate heart rate, either because the heart's natural PM is not fast enough, or there is a block in the heart's electrical conduction system. Modern PMs are externally programmable and allow the cardiologist to select the optimum pacing modes for individual patients. Some combine a PM and defibrillator in a single implantable device. PMs can be temporary or permanent. Temporary PMs are used to treat short-term heart problems, such as a slow heartbeat that's caused by a heart attack, heart surgery, or an overdose of medicine. Permanent PMs are used to control long-term heart rhythm problems. A PM can relieve some arrhythmia symptoms, such as fatigue and fainting. A PM also can help a person who has abnormal HRs resume a more active lifestyle. In the current mini review we will focus on the insertion of a PM and the possible pneumothorax that can be caused.
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Affiliation(s)
- Maria Kotsakou
- 1 Electrophysiology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece ; 2 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Oncology Department, "Papageorgiou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 4 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 5 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 6 Ear, Nose and Throat, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 7 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 8 Oncology Department, "BioMedicine" Private Clinic, Thessaloniki, Greece ; 9 2nd Pulmonary Clinic of "Sotiria" Hospital, Athens, Greece ; 10 Pulmonary Laboratory, Alexandra Hospital University, Athens, Greece ; 11 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Greece
| | - Ioannis Kioumis
- 1 Electrophysiology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece ; 2 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Oncology Department, "Papageorgiou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 4 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 5 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 6 Ear, Nose and Throat, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 7 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 8 Oncology Department, "BioMedicine" Private Clinic, Thessaloniki, Greece ; 9 2nd Pulmonary Clinic of "Sotiria" Hospital, Athens, Greece ; 10 Pulmonary Laboratory, Alexandra Hospital University, Athens, Greece ; 11 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Greece
| | - George Lazaridis
- 1 Electrophysiology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece ; 2 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Oncology Department, "Papageorgiou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 4 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 5 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 6 Ear, Nose and Throat, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 7 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 8 Oncology Department, "BioMedicine" Private Clinic, Thessaloniki, Greece ; 9 2nd Pulmonary Clinic of "Sotiria" Hospital, Athens, Greece ; 10 Pulmonary Laboratory, Alexandra Hospital University, Athens, Greece ; 11 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Greece
| | - Georgia Pitsiou
- 1 Electrophysiology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece ; 2 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Oncology Department, "Papageorgiou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 4 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 5 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 6 Ear, Nose and Throat, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 7 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 8 Oncology Department, "BioMedicine" Private Clinic, Thessaloniki, Greece ; 9 2nd Pulmonary Clinic of "Sotiria" Hospital, Athens, Greece ; 10 Pulmonary Laboratory, Alexandra Hospital University, Athens, Greece ; 11 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Greece
| | - Sofia Lampaki
- 1 Electrophysiology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece ; 2 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Oncology Department, "Papageorgiou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 4 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 5 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 6 Ear, Nose and Throat, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 7 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 8 Oncology Department, "BioMedicine" Private Clinic, Thessaloniki, Greece ; 9 2nd Pulmonary Clinic of "Sotiria" Hospital, Athens, Greece ; 10 Pulmonary Laboratory, Alexandra Hospital University, Athens, Greece ; 11 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Greece
| | - Antonis Papaiwannou
- 1 Electrophysiology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece ; 2 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Oncology Department, "Papageorgiou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 4 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 5 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 6 Ear, Nose and Throat, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 7 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 8 Oncology Department, "BioMedicine" Private Clinic, Thessaloniki, Greece ; 9 2nd Pulmonary Clinic of "Sotiria" Hospital, Athens, Greece ; 10 Pulmonary Laboratory, Alexandra Hospital University, Athens, Greece ; 11 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Greece
| | - Anastasia Karavergou
- 1 Electrophysiology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece ; 2 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Oncology Department, "Papageorgiou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 4 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 5 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 6 Ear, Nose and Throat, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 7 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 8 Oncology Department, "BioMedicine" Private Clinic, Thessaloniki, Greece ; 9 2nd Pulmonary Clinic of "Sotiria" Hospital, Athens, Greece ; 10 Pulmonary Laboratory, Alexandra Hospital University, Athens, Greece ; 11 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Greece
| | - Kosmas Tsakiridis
- 1 Electrophysiology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece ; 2 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Oncology Department, "Papageorgiou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 4 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 5 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 6 Ear, Nose and Throat, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 7 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 8 Oncology Department, "BioMedicine" Private Clinic, Thessaloniki, Greece ; 9 2nd Pulmonary Clinic of "Sotiria" Hospital, Athens, Greece ; 10 Pulmonary Laboratory, Alexandra Hospital University, Athens, Greece ; 11 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Greece
| | - Nikolaos Katsikogiannis
- 1 Electrophysiology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece ; 2 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Oncology Department, "Papageorgiou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 4 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 5 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 6 Ear, Nose and Throat, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 7 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 8 Oncology Department, "BioMedicine" Private Clinic, Thessaloniki, Greece ; 9 2nd Pulmonary Clinic of "Sotiria" Hospital, Athens, Greece ; 10 Pulmonary Laboratory, Alexandra Hospital University, Athens, Greece ; 11 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Greece
| | - Ilias Karapantzos
- 1 Electrophysiology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece ; 2 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Oncology Department, "Papageorgiou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 4 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 5 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 6 Ear, Nose and Throat, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 7 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 8 Oncology Department, "BioMedicine" Private Clinic, Thessaloniki, Greece ; 9 2nd Pulmonary Clinic of "Sotiria" Hospital, Athens, Greece ; 10 Pulmonary Laboratory, Alexandra Hospital University, Athens, Greece ; 11 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Greece
| | - Chrysanthi Karapantzou
- 1 Electrophysiology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece ; 2 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Oncology Department, "Papageorgiou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 4 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 5 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 6 Ear, Nose and Throat, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 7 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 8 Oncology Department, "BioMedicine" Private Clinic, Thessaloniki, Greece ; 9 2nd Pulmonary Clinic of "Sotiria" Hospital, Athens, Greece ; 10 Pulmonary Laboratory, Alexandra Hospital University, Athens, Greece ; 11 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Greece
| | - Sofia Baka
- 1 Electrophysiology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece ; 2 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Oncology Department, "Papageorgiou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 4 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 5 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 6 Ear, Nose and Throat, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 7 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 8 Oncology Department, "BioMedicine" Private Clinic, Thessaloniki, Greece ; 9 2nd Pulmonary Clinic of "Sotiria" Hospital, Athens, Greece ; 10 Pulmonary Laboratory, Alexandra Hospital University, Athens, Greece ; 11 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Greece
| | - Ioannis Mpoukovinas
- 1 Electrophysiology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece ; 2 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Oncology Department, "Papageorgiou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 4 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 5 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 6 Ear, Nose and Throat, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 7 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 8 Oncology Department, "BioMedicine" Private Clinic, Thessaloniki, Greece ; 9 2nd Pulmonary Clinic of "Sotiria" Hospital, Athens, Greece ; 10 Pulmonary Laboratory, Alexandra Hospital University, Athens, Greece ; 11 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Greece
| | - Vasilis Karavasilis
- 1 Electrophysiology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece ; 2 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Oncology Department, "Papageorgiou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 4 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 5 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 6 Ear, Nose and Throat, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 7 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 8 Oncology Department, "BioMedicine" Private Clinic, Thessaloniki, Greece ; 9 2nd Pulmonary Clinic of "Sotiria" Hospital, Athens, Greece ; 10 Pulmonary Laboratory, Alexandra Hospital University, Athens, Greece ; 11 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Greece
| | - Aggeliki Rapti
- 1 Electrophysiology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece ; 2 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Oncology Department, "Papageorgiou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 4 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 5 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 6 Ear, Nose and Throat, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 7 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 8 Oncology Department, "BioMedicine" Private Clinic, Thessaloniki, Greece ; 9 2nd Pulmonary Clinic of "Sotiria" Hospital, Athens, Greece ; 10 Pulmonary Laboratory, Alexandra Hospital University, Athens, Greece ; 11 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Greece
| | - Georgia Trakada
- 1 Electrophysiology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece ; 2 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Oncology Department, "Papageorgiou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 4 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 5 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 6 Ear, Nose and Throat, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 7 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 8 Oncology Department, "BioMedicine" Private Clinic, Thessaloniki, Greece ; 9 2nd Pulmonary Clinic of "Sotiria" Hospital, Athens, Greece ; 10 Pulmonary Laboratory, Alexandra Hospital University, Athens, Greece ; 11 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Greece
| | - Athanasios Zissimopoulos
- 1 Electrophysiology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece ; 2 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Oncology Department, "Papageorgiou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 4 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 5 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 6 Ear, Nose and Throat, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 7 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 8 Oncology Department, "BioMedicine" Private Clinic, Thessaloniki, Greece ; 9 2nd Pulmonary Clinic of "Sotiria" Hospital, Athens, Greece ; 10 Pulmonary Laboratory, Alexandra Hospital University, Athens, Greece ; 11 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Greece
| | - Konstantinos Zarogoulidis
- 1 Electrophysiology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece ; 2 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Oncology Department, "Papageorgiou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 4 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 5 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 6 Ear, Nose and Throat, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 7 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 8 Oncology Department, "BioMedicine" Private Clinic, Thessaloniki, Greece ; 9 2nd Pulmonary Clinic of "Sotiria" Hospital, Athens, Greece ; 10 Pulmonary Laboratory, Alexandra Hospital University, Athens, Greece ; 11 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Greece
| | - Paul Zarogoulidis
- 1 Electrophysiology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece ; 2 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Oncology Department, "Papageorgiou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 4 Thoracic Surgery Department, "Saint Luke" Private Hospital, Thessaloniki, Greece ; 5 Surgery Department, University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 6 Ear, Nose and Throat, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 7 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 8 Oncology Department, "BioMedicine" Private Clinic, Thessaloniki, Greece ; 9 2nd Pulmonary Clinic of "Sotiria" Hospital, Athens, Greece ; 10 Pulmonary Laboratory, Alexandra Hospital University, Athens, Greece ; 11 Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Greece
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9
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Poole JE, Gleva MJ, Mela T, Chung MK, Uslan DZ, Borge R, Gottipaty V, Shinn T, Dan D, Feldman LA, Seide H, Winston SA, Gallagher JJ, Langberg JJ, Mitchell K, Holcomb R. Complication Rates Associated With Pacemaker or Implantable Cardioverter-Defibrillator Generator Replacements and Upgrade Procedures. Circulation 2010; 122:1553-61. [PMID: 20921437 DOI: 10.1161/circulationaha.110.976076] [Citation(s) in RCA: 542] [Impact Index Per Article: 38.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background—
Prospective studies defining the risk associated with pacemaker or implantable cardioverter-defibrillator replacement surgeries do not exist. These procedures are generally considered low risk despite results from recent retrospective series reporting higher rates.
Methods and Results—
We prospectively assessed predefined procedure-related complication rates associated with elective pacemaker or implantable cardioverter-defibrillator generator replacements over 6 months of follow-up. Two groups were studied: those without (cohort 1) and those with (cohort 2) a planned transvenous lead addition for replacement or upgrade to a device capable of additional therapies. Complications were adjudicated by an independent events committee. Seventy-two US academic and private practice centers participated. Major complications occurred in 4.0% (95% confidence interval, 2.9 to 5.4) of 1031 cohort 1 patients and 15.3% (95% confidence interval, 12.7 to 18.1) of 713 cohort 2 patients. In both cohorts, major complications were higher with implantable cardioverter-defibrillator compared with pacemaker generator replacements. Complications were highest in patients who had an upgrade to or a revised cardiac resynchronization therapy device (18.7%; 95% confidence interval, 15.1 to 22.6). No periprocedural deaths occurred in either cohort, although 8 later procedure-related deaths occurred in cohort 2. The 6-month infection rates were 1.4% (95% confidence interval, 0.7 to 2.3) and 1.1% (95% confidence interval, 0.5 to 2.2) for cohorts 1 and 2, respectively.
Conclusions—
Pacemaker and implantable cardioverter-defibrillator generator replacements are associated with a notable complication risk, particularly those with lead additions. These data support careful decision making before device replacement, when managing device advisories, and when considering upgrades to more complex systems.
Clinical Trial Registration—
URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00395447.
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Affiliation(s)
- Jeanne E. Poole
- From the University of Washington, Seattle (J.E.P.); Washington University in St Louis, School of Medicine, St Louis, Mo (M.J.G.); Massachusetts General Hospital, Boston (T.M.); Cleveland Clinic, Cleveland, Ohio (M.K.C.); University of California Los Angeles (D.Z.U.); Abington Medical Specialists, Abington, Pa (R.B.); South Carolina Heart Center, Columbia (V.K.); Michigan Heart, Ypsilanti (T.S., S.A.W.); Piedmont Heart Institute, Atlanta, Ga (D.D.); Desert Cardiology, Rancho Mirage, Calif (L.A.F.)
| | - Marye J. Gleva
- From the University of Washington, Seattle (J.E.P.); Washington University in St Louis, School of Medicine, St Louis, Mo (M.J.G.); Massachusetts General Hospital, Boston (T.M.); Cleveland Clinic, Cleveland, Ohio (M.K.C.); University of California Los Angeles (D.Z.U.); Abington Medical Specialists, Abington, Pa (R.B.); South Carolina Heart Center, Columbia (V.K.); Michigan Heart, Ypsilanti (T.S., S.A.W.); Piedmont Heart Institute, Atlanta, Ga (D.D.); Desert Cardiology, Rancho Mirage, Calif (L.A.F.)
| | - Theofanie Mela
- From the University of Washington, Seattle (J.E.P.); Washington University in St Louis, School of Medicine, St Louis, Mo (M.J.G.); Massachusetts General Hospital, Boston (T.M.); Cleveland Clinic, Cleveland, Ohio (M.K.C.); University of California Los Angeles (D.Z.U.); Abington Medical Specialists, Abington, Pa (R.B.); South Carolina Heart Center, Columbia (V.K.); Michigan Heart, Ypsilanti (T.S., S.A.W.); Piedmont Heart Institute, Atlanta, Ga (D.D.); Desert Cardiology, Rancho Mirage, Calif (L.A.F.)
| | - Mina K. Chung
- From the University of Washington, Seattle (J.E.P.); Washington University in St Louis, School of Medicine, St Louis, Mo (M.J.G.); Massachusetts General Hospital, Boston (T.M.); Cleveland Clinic, Cleveland, Ohio (M.K.C.); University of California Los Angeles (D.Z.U.); Abington Medical Specialists, Abington, Pa (R.B.); South Carolina Heart Center, Columbia (V.K.); Michigan Heart, Ypsilanti (T.S., S.A.W.); Piedmont Heart Institute, Atlanta, Ga (D.D.); Desert Cardiology, Rancho Mirage, Calif (L.A.F.)
| | - Daniel Z. Uslan
- From the University of Washington, Seattle (J.E.P.); Washington University in St Louis, School of Medicine, St Louis, Mo (M.J.G.); Massachusetts General Hospital, Boston (T.M.); Cleveland Clinic, Cleveland, Ohio (M.K.C.); University of California Los Angeles (D.Z.U.); Abington Medical Specialists, Abington, Pa (R.B.); South Carolina Heart Center, Columbia (V.K.); Michigan Heart, Ypsilanti (T.S., S.A.W.); Piedmont Heart Institute, Atlanta, Ga (D.D.); Desert Cardiology, Rancho Mirage, Calif (L.A.F.)
| | - Richard Borge
- From the University of Washington, Seattle (J.E.P.); Washington University in St Louis, School of Medicine, St Louis, Mo (M.J.G.); Massachusetts General Hospital, Boston (T.M.); Cleveland Clinic, Cleveland, Ohio (M.K.C.); University of California Los Angeles (D.Z.U.); Abington Medical Specialists, Abington, Pa (R.B.); South Carolina Heart Center, Columbia (V.K.); Michigan Heart, Ypsilanti (T.S., S.A.W.); Piedmont Heart Institute, Atlanta, Ga (D.D.); Desert Cardiology, Rancho Mirage, Calif (L.A.F.)
| | - Venkateshwar Gottipaty
- From the University of Washington, Seattle (J.E.P.); Washington University in St Louis, School of Medicine, St Louis, Mo (M.J.G.); Massachusetts General Hospital, Boston (T.M.); Cleveland Clinic, Cleveland, Ohio (M.K.C.); University of California Los Angeles (D.Z.U.); Abington Medical Specialists, Abington, Pa (R.B.); South Carolina Heart Center, Columbia (V.K.); Michigan Heart, Ypsilanti (T.S., S.A.W.); Piedmont Heart Institute, Atlanta, Ga (D.D.); Desert Cardiology, Rancho Mirage, Calif (L.A.F.)
| | - Timothy Shinn
- From the University of Washington, Seattle (J.E.P.); Washington University in St Louis, School of Medicine, St Louis, Mo (M.J.G.); Massachusetts General Hospital, Boston (T.M.); Cleveland Clinic, Cleveland, Ohio (M.K.C.); University of California Los Angeles (D.Z.U.); Abington Medical Specialists, Abington, Pa (R.B.); South Carolina Heart Center, Columbia (V.K.); Michigan Heart, Ypsilanti (T.S., S.A.W.); Piedmont Heart Institute, Atlanta, Ga (D.D.); Desert Cardiology, Rancho Mirage, Calif (L.A.F.)
| | - Dan Dan
- From the University of Washington, Seattle (J.E.P.); Washington University in St Louis, School of Medicine, St Louis, Mo (M.J.G.); Massachusetts General Hospital, Boston (T.M.); Cleveland Clinic, Cleveland, Ohio (M.K.C.); University of California Los Angeles (D.Z.U.); Abington Medical Specialists, Abington, Pa (R.B.); South Carolina Heart Center, Columbia (V.K.); Michigan Heart, Ypsilanti (T.S., S.A.W.); Piedmont Heart Institute, Atlanta, Ga (D.D.); Desert Cardiology, Rancho Mirage, Calif (L.A.F.)
| | - Leon A. Feldman
- From the University of Washington, Seattle (J.E.P.); Washington University in St Louis, School of Medicine, St Louis, Mo (M.J.G.); Massachusetts General Hospital, Boston (T.M.); Cleveland Clinic, Cleveland, Ohio (M.K.C.); University of California Los Angeles (D.Z.U.); Abington Medical Specialists, Abington, Pa (R.B.); South Carolina Heart Center, Columbia (V.K.); Michigan Heart, Ypsilanti (T.S., S.A.W.); Piedmont Heart Institute, Atlanta, Ga (D.D.); Desert Cardiology, Rancho Mirage, Calif (L.A.F.)
| | - Hanscy Seide
- From the University of Washington, Seattle (J.E.P.); Washington University in St Louis, School of Medicine, St Louis, Mo (M.J.G.); Massachusetts General Hospital, Boston (T.M.); Cleveland Clinic, Cleveland, Ohio (M.K.C.); University of California Los Angeles (D.Z.U.); Abington Medical Specialists, Abington, Pa (R.B.); South Carolina Heart Center, Columbia (V.K.); Michigan Heart, Ypsilanti (T.S., S.A.W.); Piedmont Heart Institute, Atlanta, Ga (D.D.); Desert Cardiology, Rancho Mirage, Calif (L.A.F.)
| | - Stuart A. Winston
- From the University of Washington, Seattle (J.E.P.); Washington University in St Louis, School of Medicine, St Louis, Mo (M.J.G.); Massachusetts General Hospital, Boston (T.M.); Cleveland Clinic, Cleveland, Ohio (M.K.C.); University of California Los Angeles (D.Z.U.); Abington Medical Specialists, Abington, Pa (R.B.); South Carolina Heart Center, Columbia (V.K.); Michigan Heart, Ypsilanti (T.S., S.A.W.); Piedmont Heart Institute, Atlanta, Ga (D.D.); Desert Cardiology, Rancho Mirage, Calif (L.A.F.)
| | - John J. Gallagher
- From the University of Washington, Seattle (J.E.P.); Washington University in St Louis, School of Medicine, St Louis, Mo (M.J.G.); Massachusetts General Hospital, Boston (T.M.); Cleveland Clinic, Cleveland, Ohio (M.K.C.); University of California Los Angeles (D.Z.U.); Abington Medical Specialists, Abington, Pa (R.B.); South Carolina Heart Center, Columbia (V.K.); Michigan Heart, Ypsilanti (T.S., S.A.W.); Piedmont Heart Institute, Atlanta, Ga (D.D.); Desert Cardiology, Rancho Mirage, Calif (L.A.F.)
| | - Jonathan J. Langberg
- From the University of Washington, Seattle (J.E.P.); Washington University in St Louis, School of Medicine, St Louis, Mo (M.J.G.); Massachusetts General Hospital, Boston (T.M.); Cleveland Clinic, Cleveland, Ohio (M.K.C.); University of California Los Angeles (D.Z.U.); Abington Medical Specialists, Abington, Pa (R.B.); South Carolina Heart Center, Columbia (V.K.); Michigan Heart, Ypsilanti (T.S., S.A.W.); Piedmont Heart Institute, Atlanta, Ga (D.D.); Desert Cardiology, Rancho Mirage, Calif (L.A.F.)
| | - Kevin Mitchell
- From the University of Washington, Seattle (J.E.P.); Washington University in St Louis, School of Medicine, St Louis, Mo (M.J.G.); Massachusetts General Hospital, Boston (T.M.); Cleveland Clinic, Cleveland, Ohio (M.K.C.); University of California Los Angeles (D.Z.U.); Abington Medical Specialists, Abington, Pa (R.B.); South Carolina Heart Center, Columbia (V.K.); Michigan Heart, Ypsilanti (T.S., S.A.W.); Piedmont Heart Institute, Atlanta, Ga (D.D.); Desert Cardiology, Rancho Mirage, Calif (L.A.F.)
| | - Richard Holcomb
- From the University of Washington, Seattle (J.E.P.); Washington University in St Louis, School of Medicine, St Louis, Mo (M.J.G.); Massachusetts General Hospital, Boston (T.M.); Cleveland Clinic, Cleveland, Ohio (M.K.C.); University of California Los Angeles (D.Z.U.); Abington Medical Specialists, Abington, Pa (R.B.); South Carolina Heart Center, Columbia (V.K.); Michigan Heart, Ypsilanti (T.S., S.A.W.); Piedmont Heart Institute, Atlanta, Ga (D.D.); Desert Cardiology, Rancho Mirage, Calif (L.A.F.)
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