Registro Español de Marcapasos. XIV Informe Oficial de la Sección de Estimulación Cardiaca de la Sociedad Española de Cardiología (2016) / Spanish Pacemaker Registry. 14th Official Report of the Spanish Society of Cardiology Working Group on Cardiac Pacing (2016)

Introducción y objetivos: Se describe el resultado del análisis de los dispositivos de estimulación implantados y remitidos al Registro Español de Marcapasos en 2016. Métodos: Procesado de la información que aporta la Tarjeta Europea del Paciente Portador de Marcapasos. Resultados: Se recibió información de 115 centros hospitalarios, con un total de 12.697 tarjetas, el 32,3% de la actividad estimada. El consumo de generadores convencionales y dispositivos de resincronización fue de 818 y 79 unidades por millón habitantes respectivamente. Se implantaron 200 marcapasos sin cables. La media de edad de los pacientes que recibieron un implante fue 77,8 años y un 52% de los dispositivos se implantaron en mayores de 80 años. El 74,9% de los procedimientos fueron primoimplantes y el 23,4%, recambios de generador. Los cables endocavitarios utilizados fueron bipolares, el 82,9% con sistema de fijación activa y el 16,1% compatibles con resonancia magnética. Aunque la estimulación secuencial bicameral sigue siendo mayoritaria, se estimula en modo VVI(R) al 26,7% de los pacientes con enfermedad del nódulo sinusal y el 23,8% de aquellos con bloqueo auriculoventricular pese a estar en ritmo sinusal. Conclusiones: El consumo total de generadores de marcapasos en España ha aumentado en un 1,6% con respecto a 2015. La mayoría de los cables implantados son de fijación activa y menos del 20% tiene protección para la resonancia magnética. Los factores directamente relacionados con la elección del modo de estimulación son la edad y el sexo. En alrededor del 32% de los casos podría mejorarse la elección del modo de estimulación (AU)

Introduction and objectives: This report describes the results of analysis of implanted pacemakers reported to the Spanish Pacemaker Registry. Methods: The analysis was based on information provided by the European Pacemaker Identification Card. Results: Information was received from 115 hospitals, with a total of 12 697 cards, representing 32.3% of the estimated activity. Use of conventional and resynchronization pacemakers was 818 and 79 units per million inhabitants, respectively. A total of 200 leadless pacemakers were implanted. The mean age of the patients receiving an implant was 77.8 years, and 52% of devices were implanted in persons older than 80 years. In all, 74.9% were first implants and 23.4% corresponded to generator exchange. Endocardial leads were bipolar, 82.9% with active fixation, and 16.1% had magnetic resonance imaging protection. Most patients received bicameral sequential pacing, although single chamber pacing VVI(R) was used in 26.7% of the patients with sick sinus syndrome and in 23.8% of those with atrioventricular block, despite sinus rhythm. Conclusions: Total use of pacemaker generators in Spain has increased by 1.6% compared with 2015. Most implanted leads have active fixation and less than 20% have magnetic resonance imaging protection. Age and sex directly influenced pacing mode selection, which could be improved in around 32% of patients (AU)

Spanish Pacemaker Registry. 14th Official Report of the Spanish Society of Cardiology Working Group on Cardiac Pacing (2016).

INTRODUCTION AND OBJECTIVES: This report describes the results of analysis of implanted pacemakers reported to the Spanish Pacemaker Registry. METHODS: The analysis was based on information provided by the European Pacemaker Identification Card. RESULTS: Information was received from 115 hospitals, with a total of 12 697 cards, representing 32.3% of the estimated activity. Use of conventional and resynchronization pacemakers was 818 and 79 units per million inhabitants, respectively. A total of 200 leadless pacemakers were implanted. The mean age of the patients receiving an implant was 77.8 years, and 52% of devices were implanted in persons older than 80 years. In all, 74.9% were first implants and 23.4% corresponded to generator exchange. Endocardial leads were bipolar, 82.9% with active fixation, and 16.1% had magnetic resonance imaging protection. Most patients received bicameral sequential pacing, although single chamber pacing VVI(R) was used in 26.7% of the patients with sick sinus syndrome and in 23.8% of those with atrioventricular block, despite sinus rhythm. CONCLUSIONS: Total use of pacemaker generators in Spain has increased by 1.6% compared with 2015. Most implanted leads have active fixation and less than 20% have magnetic resonance imaging protection. Age and sex directly influenced pacing mode selection, which could be improved in around 32% of patients.

Registro Español de Marcapasos. XIII Informe Oficial de la Sección de Estimulación Cardiaca de la Sociedad Española de Cardiología (2015) / Spanish Pacemaker Registry. Thirteenth Official Report of the Spanish Society of Cardiology Working Group on Cardiac Pacing (2015)

Introducción y objetivos: Se describe el resultado del análisis de los dispositivos implantados y remitidos al Registro Español de Marcapasos en 2015. Métodos: Se basa en el procesado de la información que aporta la Tarjeta Europea del Paciente Portador de Marcapasos. Resultados: Se recibió información de 111 centros hospitalarios, con un total de 12.555 tarjetas, el 32,1% de la actividad estimada. El consumo de generadores convencionales y dispositivos de resincronización fue de 820 y 73 unidades por millón de habitantes respectivamente. La media de edad de los pacientes que recibieron un implante fue 77,7 años y más del 50% de los dispositivos se implantaron en mayores de 80 años. El 58,6% de los implantes y el 58,8% de los recambios se realizaron en varones. Los cables endocavitarios utilizados fueron bipolares, el 81,5% con sistema de fijación activa y el 16,5%, compatibles con resonancia magnética. Aunque la estimulación secuencial bicameral sigue siendo mayoritaria, se estimula en modo VVI/R pese a estar en ritmo sinusal al 23,8% de los pacientes con enfermedad del nódulo sinusal y el 24,1% de aquellos con bloqueo auriculoventricular. Conclusiones: El consumo total de generadores de marcapasos en España ha aumentado en un 5% con respecto a 2014. La mayor parte de los cables implantados son de fijación activa y menos del 20% tienen protección para la resonancia magnética. Los factores directamente relacionados con la elección del modo de estimulación son la edad y el sexo. En alrededor del 20% de los casos podría mejorarse la elección del modo de estimulación (AU)

Introduction and objectives: We describe the results of the analysis of the devices implanted and conveyed to the Spanish Pacemaker Registry in 2015. Methods: The report is based on the processing of information provided by the European Pacemaker Patient Identification Card. Results: We received information from 111 hospitals, with a total of 12 555 cards, representing 32.1% of all the estimated activity. The use of conventional generators and resynchronization devices was 820 and 73 units per million population, respectively. The mean age of the patients receiving an implantation was 77.7 years, and more than 50% of the devices were implanted in patients over 80 years of age. Overall, 58.6% of the implants and 58.8% of the replacements were performed in men. All of the endocardial leads employed were bipolar, 81.5% had an active fixation system, and 16.5% were compatible with magnetic resonance. Although dual chamber sequential pacing continues to be more widespread, pacing with VVI/R mode is used because up to 23.8% of the patients with sinus node disease are in sinus rhythm, as are 24.1% of those with atrioventricular block. Conclusions: The total use of pacemaker generators in Spain has increased by about 5% with respect to 2014. The majority of the leads implanted are of active fixation, and less than 20% are protected from magnetic resonance. The factors directly related to the selection of pacing mode are age and sex. In around 20% of patients, the choice of the pacing mode could be improved (AU)

Spanish Pacemaker Registry. Thirteenth Official Report of the Spanish Society of Cardiology Working Group on Cardiac Pacing (2015).

INTRODUCTION AND OBJECTIVES: We describe the results of the analysis of the devices implanted and conveyed to the Spanish Pacemaker Registry in 2015. METHODS: The report is based on the processing of information provided by the European Pacemaker Patient Identification Card. RESULTS: We received information from 111 hospitals, with a total of 12 555 cards, representing 32.1% of all the estimated activity. The use of conventional generators and resynchronization devices was 820 and 73 units per million population, respectively. The mean age of the patients receiving an implantation was 77.7 years, and more than 50% of the devices were implanted in patients over 80 years of age. Overall, 58.6% of the implants and 58.8% of the replacements were performed in men. All of the endocardial leads employed were bipolar, 81.5% had an active fixation system, and 16.5% were compatible with magnetic resonance. Although dual chamber sequential pacing continues to be more widespread, pacing with VVI/R mode is used because up to 23.8% of the patients with sinus node disease are in sinus rhythm, as are 24.1% of those with atrioventricular block. CONCLUSIONS: The total use of pacemaker generators in Spain has increased by about 5% with respect to 2014. The majority of the leads implanted are of active fixation, and less than 20% are protected from magnetic resonance. The factors directly related to the selection of pacing mode are age and sex. In around 20% of patients, the choice of the pacing mode could be improved.

Estimulación auriculoventricular secuencial en pacientes con miocardiopatía hipertrófica: 18 años de experiencia / Sequential atrioventricular pacing in patients with hypertrophic cardiomyopathy: An 18-year experience

Introducción y objetivos: El papel de la estimulación auriculoventricular secuencial en pacientes con miocardiopatía hipertrófica obstructiva y síntomas incapacitantes sigue siendo controvertido. El objetivo de este trabajo es valorar su efecto en los síntomas, el gradiente dinámico y la función del ventrículo izquierdo. Métodos: Desde 1991 a 2009, se implantó un marcapasos bicameral a 82 pacientes con miocardiopatía hipertrófica obstructiva y síntomas incapacitantes a pesar de tratamiento médico óptimo. Se programó una estimulación secuencial con un intervalo auriculoventricular corto. Se analizaron parámetros clínicos y ecocardiográficos antes, inmediatamente tras el implante y al final de un largo seguimiento (mediana, 8,5 [1-18] años). Resultados: La clase funcional de la New York Heart Association se redujo inmediatamente tras el implante en el 95% de los pacientes (p < 0,0001), y esta mejoría se mantenía al final del seguimiento en el 89% (p = 0,016). Se observó una reducción significativa del gradiente tras el implante (94,5 ± 36,5 frente a 46,4 ± 26,7 mmHg; p < 0,0001) y al final del seguimiento (94,5 ± 36,5 frente a 35,9 ± 24,0 mmHg; p < 0,0001). La insuficiencia mitral mejoró de manera constante en el 52% de los casos (p < 0,0001). No hubo diferencias en el grosor o los diámetros ventriculares, la fracción de eyección o la función diastólica. Conclusiones: La estimulación secuencial en pacientes seleccionados con miocardiopatía hipertrófica obstructiva mejora la clase funcional y reduce el gradiente dinámico y la insuficiencia mitral inmediatamente tras el implante y al final de un largo seguimiento. La estimulación ventricular prolongada no produce efectos deletéreos en la función ventricular sistólica o diastólica en estos pacientes (AU)

Introduction and objectives: Controversy persists regarding the role of sequential atrioventricular pacing in patients with obstructive hypertrophic cardiomyopathy and disabling symptoms. The aim of this study was to evaluate the effect of pacing on symptoms, dynamic gradient, and left ventricular function in patients with hypertrophic cardiomyopathy. Methods: From 1991 to 2009, dual-chamber pacemakers were implanted in 82 patients with obstructive hypertrophic cardiomyopathy and disabling symptoms despite optimal medical therapy. Sequential pacing was performed with a short atrioventricular delay. Clinical and echocardiographic parameters were measured before and immediately after implantation and after a long follow-up (median, 8.5 years [range, 1-18 years]). Results: The New York Heart Association functional class was immediately reduced after pacemaker implantation in 95% of patients (P < .0001), and this improvement was maintained until the final follow-up in 89% (P = .016). The gradient was significantly reduced after implantation (94.5 ± 36.5 vs 46.4 ± 26.7 mmHg; P < .0001) and at final follow-up (94.5 ± 36.5 vs 35.9 ± 24.0 mmHg; P < .0001). Mitral regurgitation permanently improved in 52% of the patients (P < .0001). There were no differences in ventricular thickness or diameters, ejection fraction, or diastolic function. Conclusions: Sequential pacing in selected patients with obstructive hypertrophic cardiomyopathy improves functional class and reduces dynamic gradient and mitral regurgitation immediately after pacemaker implantation and at final follow-up. Prolonged ventricular pacing has no negative effects on systolic or diastolic function in these patients (AU)

Sequential Atrioventricular Pacing in Patients With Hypertrophic Cardiomyopathy: An 18-year Experience.

INTRODUCTION AND OBJECTIVES: Controversy persists regarding the role of sequential atrioventricular pacing in patients with obstructive hypertrophic cardiomyopathy and disabling symptoms. The aim of this study was to evaluate the effect of pacing on symptoms, dynamic gradient, and left ventricular function in patients with hypertrophic cardiomyopathy. METHODS: From 1991 to 2009, dual-chamber pacemakers were implanted in 82 patients with obstructive hypertrophic cardiomyopathy and disabling symptoms despite optimal medical therapy. Sequential pacing was performed with a short atrioventricular delay. Clinical and echocardiographic parameters were measured before and immediately after implantation and after a long follow-up (median, 8.5 years [range, 1-18 years]). RESULTS: The New York Heart Association functional class was immediately reduced after pacemaker implantation in 95% of patients (P < .0001), and this improvement was maintained until the final follow-up in 89% (P = .016). The gradient was significantly reduced after implantation (94.5 ± 36.5 vs 46.4 ± 26.7mmHg; P < .0001) and at final follow-up (94.5 ± 36.5 vs 35.9 ± 24.0mmHg; P < .0001). Mitral regurgitation permanently improved in 52% of the patients (P < .0001). There were no differences in ventricular thickness or diameters, ejection fraction, or diastolic function. CONCLUSIONS: Sequential pacing in selected patients with obstructive hypertrophic cardiomyopathy improves functional class and reduces dynamic gradient and mitral regurgitation immediately after pacemaker implantation and at final follow-up. Prolonged ventricular pacing has no negative effects on systolic or diastolic function in these patients.

Registro Español de Marcapasos. XII Informe Oficial de la Sección de Estimulación Cardiaca de la Sociedad Española de Cardiología (2014) / Spanish pacemaker registry. Twelfth official report of the Spanish society of cardiology working group on cardiac pacing (2014)

Introducción y objetivos: Se describe el resultado del análisis de los implantes y recambios de marcapasos remitidos al Registro Español de Marcapasos en 2014, con especial referencia a la selección de los modos de estimulación. Métodos: Se basa en el procesado de la información que aporta la Tarjeta Europea del Paciente Portador de Marcapasos. Resultados: Se recibió información de 117 centros hospitalarios, con un total de 12.358 tarjetas, el 34% de la actividad estimada. El consumo de generadores convencionales y dispositivos de resincronización fue de 784 y 64,4 unidades por millón de habitantes respectivamente. La media de edad de los pacientes que recibieron un implante fue 77,3 años. El 59% de los implantes y el 56,4% de los recambios se realizaron en varones. La mayoría de los implantes y los recambios de generadores se produjeron en la franja de los 80–89 años. Los cables endocavitarios utilizados son bipolares, el 84,2% con sistema de fijación activa. Se estimula en modo VVI/R pese a estar en ritmo sinusal al 24,7% de los pacientes con enfermedad del nódulo sinusal y el 24% de aquellos con bloqueo auriculoventricular. Conclusiones: Continúa el aumento en el consumo de generadores de marcapasos y dispositivos de resincronización por millón de habitantes. La mayor parte de los cables implantados son de fijación activa y aproximadamente un 20% tiene protección para resonancia magnética. La edad y el sexo se muestran como factores directamente relacionados con la elección del modo de estimulación. En más del 20% de los casos podría mejorarse la elección del modo de estimulación (AU)

Introduction and objectives: This report describes the results of the analysis of pacemaker implant and replacement data submitted to the Spanish Pacemaker Registry in 2014, with special reference to pacing mode selection. Methods: The report is based on the processing of information provided by the European Pacemaker Patient Identification Card. Results: Information was received from 117 hospitals, with a total of 12 358 cards, representing 34% of estimated activity. Use of conventional generators and resynchronization devices was 784 and 64.4 units per million population, respectively. The mean age of patients receiving an implant was 77.3 years. Men received 59% of implants and 56.4% of replacements. Most patients receiving generator implants and replacements were in the age range 80 to 89 years. Most endocardial leads used were bipolar, and 84.2% had an active fixation system. Pacing was in VVI/R mode despite being in sinus rhythm in 24.7% of patients with sick sinus syndrome and 24% of those with atrioventricular block. Conclusions: The use of pacemaker generators and resynchronization devices per million population continued to increase. Most implanted leads had active fixation and approximately 20% had magnetic resonance imaging protection. Age and sex directly influenced pacing mode selection, which could have been improved in more than 20% of cases (AU)

Spanish Pacemaker Registry. Twelfth Official Report of the Spanish Society of Cardiology Working Group on Cardiac Pacing (2014).

INTRODUCTION AND OBJECTIVES: This report describes the results of the analysis of pacemaker implant and replacement data submitted to the Spanish Pacemaker Registry in 2014, with special reference to pacing mode selection. METHODS: The report is based on the processing of information provided by the European Pacemaker Patient Identification Card. RESULTS: Information was received from 117 hospitals, with a total of 12 358 cards, representing 34% of estimated activity. Use of conventional generators and resynchronization devices was 784 and 64.4 units per million population, respectively. The mean age of patients receiving an implant was 77.3 years. Men received 59% of implants and 56.4% of replacements. Most patients receiving generator implants and replacements were in the age range 80 to 89 years. Most endocardial leads used were bipolar, and 84.2% had an active fixation system. Pacing was in VVI/R mode despite being in sinus rhythm in 24.7% of patients with sick sinus syndrome and 24% of those with atrioventricular block. CONCLUSIONS: The use of pacemaker generators and resynchronization devices per million population continued to increase. Most implanted leads had active fixation and approximately 20% had magnetic resonance imaging protection. Age and sex directly influenced pacing mode selection, which could have been improved in more than 20% of cases.

Spanish Pacemaker Registry. Eleventh official report of the Spanish Society of Cardiology Working Group on Cardiac Pacing (2013).

INTRODUCTION AND OBJECTIVES: The present report summarizes the analysis of pacemaker implantation and replacement data sent to the Spanish Pacemaker Registry in 2013, with specific discussion of pacing mode selection. METHODS: This study was based on information obtained from the European Pacemaker Patient Identification Card. RESULTS: Information was received on 118 hospital centers, with a total of 12 831 cards, or 35% of the estimated activity. There were 755 and 58.1 conventional and resynchronization devices per million population, respectively. The mean age of patients receiving an implant was 77.4 years. Men received 59.5% of first implantations and 56.6% of replacements. Most implantations and generator replacements were performed in patients older than 80 years. Almost all endocardial leads used were bipolar, and 78.7% of leads had an active fixation mechanism. Despite being in sinus rhythm, 24% of patients with sick sinus syndrome and 25% of those with atrioventricular block were paced in VVIR mode. CONCLUSIONS: The use of pacemaker generators and resynchronization devices per million population continues to increase in Spain. Active fixation mechanisms predominate for leads but just 20% of leads are compatible with magnetic resonance imaging. The factors influencing the correct selection of pacing mode were age and, to a lesser extent, the type of atrioventricular block, and sex. Implementation of home monitoring of pacemakers remains low.

Registro Español de Marcapasos. XI Informe Oficial de la Sección de Estimulación Cardiaca de la Sociedad Española de Cardiología (2013) / Spanish Pacemaker Registry. Eleventh Official Report of the Spanish Society of Cardiology Working Group on Cardiac Pacing (2013)

Introducción y objetivos. Se describe el resultado del análisis de los implantes y recambios de marcapasos remitidos al Registro Español de Marcapasos en 2013, con especial referencia a selección de los modos de estimulación. Métodos. Se basa en el procesado de la información que aporta la Tarjeta Europea del Paciente Portador de Marcapasos. Resultados. Se recibió información de 118 centros hospitalarios, con un total de 12.831 tarjetas, el 35% de la actividad estimada. El consumo de generadores convencionales y dispositivos de resincronización fue de 755 y 58,1 unidades por millón de habitantes respectivamente. La media de edad de los pacientes que recibieron un implante era 77,4 años. El 59,5% de los implantes y el 56,6% de los recambios se realizaron en varones. La mayoría de los implantes y recambios de generadores se produjeron en la franja de los 80 años. Los cables endocavitarios utilizados son bipolares, el 78,7% con sistema de fijación activa. Se estimula en modo VVI/R pese a estar en ritmo sinusal al 24% de los pacientes con enfermedad del nódulo sinusal y el 25% de aquellos con bloqueo auriculoventricular. Conclusiones. Persiste la tendencia a aumentar del consumo de generadores marcapasos y dispositivos de resincronización por millón de habitantes. El sistema de fijación activa de los cables es mayoritario y un 20%, específico de protección de resonancia magnética. La edad y, en menor grado, el tipo de bloqueo auriculoventricular y el sexo son los factores que influyen en la adecuación del modo de estimulación. La monitorización domiciliaria de marcapasos aún dista mucho de generalizarse (AU)

Introduction and objectives. The present report summarizes the analysis of pacemaker implantation and replacement data sent to the Spanish Pacemaker Registry in 2013, with specific discussion of pacing mode selection. Methods. This study was based on information obtained from the European Pacemaker Patient Identification Card. Results. Information was received on 118 hospital centers, with a total of 12 831 cards, or 35% of the estimated activity. There were 755 and 58.1 conventional and resynchronization devices per million population, respectively. The mean age of patients receiving an implant was 77.4 years. Men received 59.5% of first implantations and 56.6% of replacements. Most implantations and generator replacements were performed in patients older than 80 years. Almost all endocardial leads used were bipolar, and 78.7% of leads had an active fixation mechanism. Despite being in sinus rhythm, 24% of patients with sick sinus syndrome and 25% of those with atrioventricular block were paced in VVIR mode. Conclusions. The use of pacemaker generators and resynchronization devices per million population continues to increase in Spain. Active fixation mechanisms predominate for leads but just 20% of leads are compatible with magnetic resonance imaging. The factors influencing the correct selection of pacing mode were age and, to a lesser extent, the type of atrioventricular block, and sex. Implementation of home monitoring of pacemakers remains low (AU)

Registro Español de Marcapasos. X Informe Oficial de la Sección de Estimulación Cardiaca de la Sociedad Española de Cardiología (2012) / Spanish Pacemaker Registry. 10th Official Report of the Spanish Society of Cardiology Working Group on Cardiac Pacing (2012)

Introducción y objetivos. Se describe el análisis de la actividad con implantes y recambios de marcapasos remitidos en 2012 al Registro Español de Marcapasos, con especial referencia a la selección de los modos de estimulación. Método. Se basa en la información que aporta la Tarjeta Europea del Paciente Portador de Marcapasos. Resultados. Se recibieron datos de 115 centros hospitalarios, con un total de 12.856 tarjetas. Se estima un consumo de generadores convencionales y resincronizadores de 745,8 y 53,1 unidades por millón de habitantes, respectivamente. Se utilizan cables con sistema de fijación activa en más del 70% de los casos, el 20% con protección para resonancia magnética. La indicación electrocardiográfica más frecuente es el bloqueo auriculoventricular (56%). Se estimula en modo VVI /R al 28% de los pacientes con enfermedad del nódulo sinusal. Conclusiones. Se estabiliza el uso de marcapasos convencionales y disminuyen los implantes de resincronizadores. El uso del sistema de fijación activa de los cables ya es mayoritario. Se confirma la mayor incidencia de implantes en los varones y a menor edad por mayor frecuencia de trastornos de conducción. La edad influye en la adecuación del modo de estimulación (AU)

Introduction and objectives. Our aim was to analyze the pacemaker implantations and replacements reported to the Spanish Pacemaker Registry in 2012 with special reference to the selection of pacing modes. Method. The analysis was based on information provided by the European Pacemaker Patient Identification Card. Results. Data were received from 115 hospitals, with a total of 12 856 cards. An estimated 745.8 pacemaker generators and 53.1 resynchronization devices were implanted per million population. Active fixation leads were implanted in more than 70% of the patients; of these leads, more than 20% were safe for use with magnetic resonance. The most common electrocardiographic indication for pacemaker implantation was atrioventricular block (56%). In all, 28% of the patients with sick sinus syndrome were paced in VVIR mode. Conclusions. The use of conventional pacemakers remained stable, whereas the implantation of resynchronization devices increased. Active fixation leads are now employed in most patients. The findings of this study confirm the higher incidence of implantation in men and at an earlier age due to the higher rate of conduction disorders. Age is a factor that influences the choice of the appropriate pacing mode (AU)

Spanish pacemaker registry. 10th official report of the Spanish Society of Cardiology Working Group on Cardiac Pacing (2012).

INTRODUCTION AND OBJECTIVES: Our aim was to analyze the pacemaker implantations and replacements reported to the Spanish Pacemaker Registry in 2012 with special reference to the selection of pacing modes. METHOD: The analysis was based on information provided by the European Pacemaker Patient Identification Card. RESULTS: Data were received from 115 hospitals, with a total of 12 856 cards. An estimated 745.8 pacemaker generators and 53.1 resynchronization devices were implanted per million population. Active fixation leads were implanted in more than 70% of the patients; of these leads, more than 20% were safe for use with magnetic resonance. The most common electrocardiographic indication for pacemaker implantation was atrioventricular block (56%). In all, 28% of the patients with sick sinus syndrome were paced in VVIR mode. CONCLUSIONS: The use of conventional pacemakers remained stable, whereas the implantation of resynchronization devices increased. Active fixation leads are now employed in most patients. The findings of this study confirm the higher incidence of implantation in men and at an earlier age due to the higher rate of conduction disorders. Age is a factor that influences the choice of the appropriate pacing mode.

Registro Español de Marcapasos. IX Informe Oficial de la Sección de Estimulación Cardiaca de la Sociedad Española de Cardiología (2011) / Spanish Pacemaker Registry. Ninth Official Report of the Spanish Society of Cardiology Working Group on Cardiac Pacing (2011)

Introducción y objetivos. Se describe el resultado del análisis de la actividad con marcapasos remitidos en 2011 al Registro Español de Marcapasos, con especial referencia a la distribución poblacional y la selección de los modos de estimulación. Métodos. Procesado de la información de la Tarjeta Europea del Paciente Portador de Marcapasos con una aplicación informática específica. Resultados. Se analiza la información de 115 centros hospitalarios, un total de 13.373 tarjetas, lo que corresponde al 38% de la actividad estimada. El consumo de generadores convencionales y dispositivos de resincronización fue de 738 y 56,2 unidades por millón habitantes, respectivamente. La media de edad de los pacientes que recibieron un implante fue 76,7 años. El 57,2% de los implantes y el 56,5% de los recambios se realizaron en varones. La mayoría de los implantes (38,7%) y recambios de generadores (41,9%) se produjeron en la franja de 80-89 años. El 99,7% de los cables utilizados eran bipolares; el 63%, con sistema de fijación activa. A más del 20% de los pacientes con bloqueo auriculoventricular o enfermedad del nódulo sinusal se los estimula en modo VVI/R pese a estar en ritmo sinusal. Conclusiones. Respecto a años previos, se ha estabilizado el uso de marcapasos convencionales y han aumentado los implantes de resincronizadores. Persiste la mayor incidencia de implantes en los varones y a menor edad. La edad y el grado de bloqueo se muestran influyentes en la adecuación del modo de estimulación (AU)

Introduction and objectives. To describe the results of the analysis of pacemaker implantations reported to the Spanish Pacemaker Registry in 2011, with particular reference to the population distribution and the selection of pacing modes. Methods. Information provided by the European Pacemaker Patient Identification Card was processed using a purpose-built computer application. Results. Data from 115 hospitals were analyzed, totaling 13 373 cards, representing an estimated 38% of implantations. The number of pacemaker generators and resynchronization devices implanted was 738 and 56.2 units per million population, respectively. The mean age of the patients who received a device was 76.7 years. Overall, 57.2% of first implantations and 56.5% of replacements were performed in men. Most implantations (38.7%) and generator replacements (41.9%) were performed in patients aged between 80 and 89 years. Of the pacemaker leads used, 99.7% were bipolar and 63% used an active fixation system. Overall, 20% of the patients with atrioventricular block or sick sinus syndrome were paced in VVI/R mode despite being in sinus rhythm. Conclusions. With respect to previous years, the use of conventional pacemakers remained stable and the implantation of resynchronization devices has increased. The number of implantation procedures continues to be higher in men and in younger patients. Age and the degree of blockage remain as factors influencing the appropriate choice of pacing mode (AU)

Spanish Pacemaker Registry. Ninth official report of the Spanish Society of Cardiology Working Group on Cardiac Pacing (2011).

INTRODUCTION AND OBJECTIVES: To describe the results of the analysis of pacemaker implantations reported to the Spanish Pacemaker Registry in 2011, with particular reference to the population distribution and the selection of pacing modes. METHODS: Information provided by the European Pacemaker Patient Identification Card was processed using a purpose-built computer application. RESULTS: Data from 115 hospitals were analyzed, totaling 13,373 cards, representing an estimated 38% of implantations. The number of pacemaker generators and resynchronization devices implanted was 738 and 56.2 units per million population, respectively. The mean age of the patients who received a device was 76.7 years. Overall, 57.2% of first implantations and 56.5% of replacements were performed in men. Most implantations (38.7%) and generator replacements (41.9%) were performed in patients aged between 80 and 89 years. Of the pacemaker leads used, 99.7% were bipolar and 63% used an active fixation system. Overall, 20% of the patients with atrioventricular block or sick sinus syndrome were paced in VVI/R mode despite being in sinus rhythm. CONCLUSIONS: With respect to previous years, the use of conventional pacemakers remained stable and the implantation of resynchronization devices has increased. The number of implantation procedures continues to be higher in men and in younger patients. Age and the degree of blockage remain as factors influencing the appropriate choice of pacing mode.

Registro Español de Marcapasos. VIII Informe Oficial de la Sección de Estimulación Cardiaca de la Sociedad Española de Cardiología (2010) / Spanish Pacemaker Registry. Eighth Official Report of the Spanish Society of Cardiology Working Group on Cardiac Pacing (2010)

Introducción y objetivos. En este artículo se describe el análisis de los implantes y recambios de marcapasos remitidos al Registro Español de Marcapasos en 2010, con especial referencia a la selección de los modos de estimulación. Métodos. La recogida de datos se basa en la información de la Tarjeta Europea del Paciente Portador de Marcapasos, que se procesa mediante una aplicación informática específica. Resultados. Se recibió información de 101 centros hospitalarios, con un total de 11.648 tarjetas. Se estima un consumo de 738 generadores por millón de habitantes. Entre los varones hay mayor incidencia de implantes de marcapasos y a una media de edad más baja. El 95,5% de los cables de estimulación utilizados fueron bipolares, el 56% con sistema de fijación activa y el 60% en cavidad auricular. La indicación electrocardiográfica más frecuente es el bloqueo auriculoventricular, seguida de la enfermedad del nódulo sinusal. El 24% de los pacientes con bloqueo auriculoventricular y el 25,6% con enfermedad del nódulo sinusal se estimulan en modo VVI/R (el 12% de unos y otros entre los pacientes de 80 o menos años). Los dispositivos de resincronización cardiaca alcanzan 47 unidades por millón de habitantes; un 25,7% no tiene desfibrilador automático implantable asociado. Conclusiones. Persiste el aumento del consumo de generadores de marcapasos. Los cables de estimulación que se utilizan son bipolares, y en su mayoría son de fijación activa. La edad sigue siendo un factor influyente en la adecuación del modo de estimulación en las diversas afecciones. La elección del modo de estimulación se puede mejorar en más del 20% (AU)

Introduction and objectives. Our aim is to describe the analysis of the pacemaker implants and replacements reported to the Spanish Pacemaker Registry in 2010, with special reference to the selection of pacing modes. Methods. Data collection was based on the information provided by the European Pacemaker Patient Identification Card, which was processed using a specially designed computer application. Results. Information was received from 101 hospitals, covering a total of 11 648 cards. An estimated 738 pacemaker generators per million population were placed in 2010. The number of pacemaker implantations is higher and the mean age of the recipients lower among men. Overall, 95.5% of the pacemaker leads used were bipolar, 56% employed an active fixation system, and 60% were placed in atrium. The most common electrocardiographic indication was atrioventricular block, followed by sick sinus syndrome. Twenty-four percent of the patients with atrioventricular block and 25.6% of those with sick sinus syndrome are being paced in VVI/R mode (12% of the patients in each group are aged 80 years or under). Cardiac resynchronization device implantation has reached the level of 47 units per million population, 25.7% of which are not associated with implantable cardioverter defibrillators. Conclusions. The upward trend in the use of pacemaker generators continues. The pacemaker leads used are predominantly bipolar, and the majority are active fixation leads. Age remains a factor in the choice of the appropriate pacing mode for the different types of heart disease. This choice could be improved in more than 20% of the cases of pacemaker implantation (AU)

[Spanish pacemaker registry. Eighth official report of the Spanish Society of Cardiology Working Group on Cardiac Pacing (2010)]. / Registro Español de Marcapasos. VIII Informe Oficial de la Sección de Estimulación Cardiaca de la Sociedad Española de Cardiología (2010).

INTRODUCTION AND OBJECTIVES: Our aim is to describe the analysis of the pacemaker implants and replacements reported to the Spanish Pacemaker Registry in 2010, with special reference to the selection of pacing modes. METHODS: Data collection was based on the information provided by the European Pacemaker Patient Identification Card, which was processed using a specially designed computer application. RESULTS: Information was received from 101 hospitals, covering a total of 11 648 cards. An estimated 738 pacemaker generators per million population were placed in 2010. The number of pacemaker implantations is higher and the mean age of the recipients lower among men. Overall, 95.5% of the pacemaker leads used were bipolar, 56% employed an active fixation system, and 60% were placed in atrium. The most common electrocardiographic indication was atrioventricular block, followed by sick sinus syndrome. Twenty-four percent of the patients with atrioventricular block and 25.6% of those with sick sinus syndrome are being paced in VVI/R mode (12% of the patients in each group are aged 80 years or under). Cardiac resynchronization device implantation has reached the level of 47 units per million population, 25.7% of which are not associated with implantable cardioverter defibrillators. CONCLUSIONS: The upward trend in the use of pacemaker generators continues. The pacemaker leads used are predominantly bipolar, and the majority are active fixation leads. Age remains a factor in the choice of the appropriate pacing mode for the different types of heart disease. This choice could be improved in more than 20% of the cases of pacemaker implantation.

Spanish Pacemaker Registry. Seventh official report of the Spanish Society of Cardiology Working Group on Cardiac Pacing (2009).

INTRODUCTION AND OBJECTIVES: This article describes the finding of an analysis of all pacemaker implants reported to the Spanish Pacemaker Registry in 2009. Particular attention is paid to patients' demographic characteristics and to the pacing modes selected for various electrocardiographic indications. METHODS: The information provided by the European Pacemaker Identification Card was analyzed using a specially developed computer program. RESULTS: Data were received from 106 centers, covering a total of 11,939 cards and corresponding to 35% of all pacemakers implanted. The average age of patients receiving pacemakers was 76.6 years. Overall, 58.4% of pacemakers were implanted in men. The largest number of electrocardiographic indications for a pacemaker was for third-degree atrioventricular block, which comprised 56% of all atrioventricular blocks. The VVIR pacing mode was used for 24.0% of patients with sick sinus syndrome and 23.5% with atrioventricular block. Over 50% of leads employed an active fixation system, and 65% were placed in the atrium. CONCLUSIONS: The trend of increasing pacemaker use continued in 2009, reaching 729 units per million population. Pacemaker implantation was more frequent in males, who received them at a slightly younger age than women. Age was a more significant determinant of inappropriate pacing mode selection than electrocardiographic abnormalities. Active fixation of pacemaker leads was used in more than 50% of cases.

Registro Español de Marcapasos. VII Informe Oficial de la Sección de Estimulación Cardiaca de la Sociedad Española de Cardiología (2009) / Spanish Pacemaker Registry. Seventh Official Report of the Spanish Society of Cardiology Working Group on Cardiac Pacing (2009)

Introducción y objetivos. Se describe el análisis de los implantes de marcapasos remitidos al Registro Español de Marcapasos de 2009, con especial referencia a la distribución poblacional y la selección de los modos de estimulación en las diversas indicaciones electrocardiográficas. Métodos. Procesamiento de la información aportada por la Tarjeta Europea del Paciente Portador de Marcapasos en sus diversos campos empleando una aplicación informática específica. Resultados. Se recibió información de 106 centros, con un total de 11.939 tarjetas, el 35% de todos los marcapasos implantados. La media de edad del paciente que recibió el implante era 76,6 años. El 58,4% de los implantes se hicieron en varones. El mayor número de las indicaciones electrocardiográficas de los implantes fueron los bloqueos auriculoventriculares de tercer grado; los bloqueos auriculoventriculares fueron el 56%. Se estimuló en modo VVI/R al 24% de los pacientes con enfermedad del nódulo sinusal y el 23,5% de aquellos con bloqueos auriculoventriculares. Los cables utilizados fueron bipolares y más del 50% con sistema de fijación activa, el 65% en la posición auricular. Conclusiones. En 2009 persiste la tendencia al aumento del consumo de generadores de marcapasos (729/millón de habitantes), con mayor incidencia en los varones y a una edad ligeramente inferior que en las mujeres. El factor edad es más determinante que la alteración electrocardiográfica en la inadecuada selección del modo de estimulación. La elección de fijación activa de los cables supera el 50% (AU)

Introduction and objectives. This article describes the finding of an analysis of all pacemaker implants reported to the Spanish Pacemaker Registry in 2009. Particular attention is paid to patients’ demographic characteristics and to the pacing modes selected for various electrocardiographic indications. Methods. The information provided by the European Pacemaker Identification Card was analyzed using a specially developed computer program. Results. Data were received from 106 centers, covering a total of 11,939 cards and corresponding to 35% of all pacemakers implanted. The average age of patients receiving pacemakers was 76.6 years. Overall, 58.4% of pacemakers were implanted in men. The largest number of electrocardiographic indications for a pacemaker was for third-degree atrioventricular block, which comprised 56% of all atrioventricular blocks. The VVIR pacing mode was used for 24.0% of patients with sick sinus syndrome and 23.5% with atrioventricular block. Over 50% of leads employed an active fixation system, and 65% were placed in the atrium. Conclusions. The trend of increasing pacemaker use continued in 2009, reaching 729 units per million population. Pacemaker implantation was more frequent in males, who received them at a slightly younger age than women. Age was a more significant determinant of inappropriate pacing mode selection than electrocardiographic abnormalities. Active fixation of pacemaker leads was used in more than 50% of cases (AU)

Registro Español de Marcapasos. VI Informe Oficial de la Sección de Estimulación Cardiaca de la Sociedad Española de Cardiología (2008) / Spanish Pacemaker Registry. 6th Official Report of the Spanish Society of Cardiology Working Group on Cardiac Pacing (2008)

Introducción y objetivos. En este artículo se describe el resultado del análisis de los implantes y recambios de marcapasos remitidos en 2008 al Registro Español de Marcapasos. Métodos. La recogida de datos se basa en la información de la Tarjeta Europea del Paciente Portador de Marcapasos. Resultados. Se recibió información de 116 centros hospitalarios, con un total de 11.855 tarjetas que suponen el 36,3% de los marcapasos implantados. Se objetiva un notable aumento del número de unidades consumidas, alcanzando 708,3 por millón de habitantes. Existe una mayor incidencia de implantes de marcapasos y a una media de edad más baja en varones, correspondiendo a la década de los setenta el mayor número de implantes, con el 39,1% del total. Los bloqueos auriculoventriculares aparecen como la más frecuente de las indicaciones electrocardiográficas. En los cables utilizados, el empleo del sistema de fijación activa supone el 59,3% de los auriculares y el 37% de los ventriculares. Se observa una mejor selección del modo de estimulación, siendo la edad un factor determinante, como por ejemplo en la enfermedad del nódulo sinusal, en la que se utiliza el modo VVI/R en el 29% de pacientes mayores de 80 años frente al 14% en los de edad inferior. Conclusiones. La edad es un factor que se muestra influyente en la adecuación del modo de estimulación. Aumenta la selección del sistema de fijación activa, alcanzando el 44,5% de los cables utilizados. La estimulación auriculoventricular registra el más alto porcentaje de utilización de todos los años analizados (AU)

Introduction and objectives. This article describes the findings of an analysis of data on pacemaker implantations and replacements reported to the Spanish Pacemaker Registry during 2008. Methods. The data came primarily from information recorded on European Pacemaker Patient Identification Cards. Results. Data were received from 116 hospital units, which submitted a total of 11,855 identification cards representing 36.3% of all pacemakers implanted. There was a marked increase in the number of pacemaker units used, which rose to a rate of 708.3 per million inhabitants. The frequency of pacemaker implantation increased and the mean age of male patients decreased. The largest number of implantations were carried out in patients in their 70s, who comprised 39.1% of the total. The most frequent electrocardiographic indication was atrioventricular block. With regard to pacing leads, active fixation leads were used in the atrium in 59.3% of cases and in the ventricle in 37.9% of cases. There was an improvement in the choice of pacing mode, with age being a determining factor. For example, in sick sinus syndrome, the VVI/R mode was used in a 29% of patients aged over 80 years compared with 14% of those aged under 80 years. Conclusions. Age was found to be one factor influencing the selection of the most appropriate pacing mode. Active fixation leads were used more often, reaching 44.5% of leads implanted. Atrioventricular pacing was used in a greater percentage of cases than in any other time period covered by the pacemaker registry (AU)

Spanish Pacemaker Registry. Fifth official report of the Spanish Society of Cardiology Working Group on Cardiac Pacing (2007).

INTRODUCTION AND OBJECTIVES: The aim of this article was to report findings from the Spanish Pacemaker Registry on procedures carried out in 2007. The analysis includes details of patients' demographic characteristics, the type of procedure (i.e., implant or replacement), pacing mode, and the electrode and fixation systems used. METHODS: The data collected comprised all the information recorded on European Pacemaker Patient Identification Cards, which were submitted voluntarily in either electronic or paper form. RESULTS: The information received from 114 health-care centers included 11 360 cards, which covered 36.9% of all pacemakers thought to be implanted during 2007. Some 680.4 pacemakers were used per million inhabitants. Usage varied significantly between different Spanish autonomous regions, partly due to uneven ageing of the population. Some 25.3% of all procedures were to replace generators. The average age of patients undergoing a first implantation was 76.1 years, with a difference between the sexes: 75.4 years in men and 77.1 years in women. First implantations were carried out most often in patients in their 70s, who comprised 40% of the total, compared with other decades of life. There were more first implantations in men, who accounted for 57.9% of the total, due to a higher incidence of intraventricular conduction disturbance. In contrast, sick sinus syndrome was equally common in both sexes. Leaving aside patients with atrial tachyarrhythmia, it was observed that the VVI/R mode was used in 26.2% of those with sick sinus syndrome, 28% with atrioventricular block and 28.1% with intraventricular conduction disturbance. Age had a great influence on whether this pacing mode was selected. Almost all leads used were bipolar. The percentage using active fixation increased to 36.5%. The percentage of implants involving low-energy cardiac resynchronization therapy remained unchanged. CONCLUSIONS: The Spanish Pacemaker Registry received data on a highly representative sample of patients requiring cardiac pacing in 2007, which covered 11 360 device implantations or replacements. It was observed that the incidence of first implantations was influenced by sex, being greater in males, who underwent implantation at a younger age because conduction disturbances were more common. Age was one factor influencing the pacing mode selected for a range of electrocardiographic indications for pacing. Almost all leads implanted were bipolar. The percentage using active fixation continues to increase.