The Australian and New Zealand cardiac pacing and implantable cardioverter-defibrillator survey: calendar year 2009.

BACKGROUND: A pacemaker (PM) and Implantable Cardioverter-Defibrillator (ICD) Survey was undertaken in Australia and New Zealand for the calendar year 2009. RESULTS AND CONCLUSIONS: For 2009, the number of new implants for Australia was 12,523 (11,850 in 2005) and 1277 for New Zealand (1134 in 2005). The number of new PM implants per million population was 565 for Australia (590 in 2005) and 299 for New Zealand (275 in 2005). Both countries had substantial increases in PM replacements. There were 446 biventricular PMs implanted in Australia (461 in 2005) and 45 in New Zealand (16 in 2005). Pulse generator types were predominantly dual chamber with 71% for Australia (72% in 2005) and 54% for New Zealand (51% in 2005). Transvenous pacing leads were overwhelmingly bipolar with marked increases in the use of active fixation leads; Australia 80% atrium, 75% ventricle and New Zealand 65% atrium, 62% ventricle. There was also a marked increase in the number of new ICDs implanted; Australia 3555 (2864 in 2005) and New Zealand 329 (134 in 2005). The new ICD implants per million population were 160 for Australia (142 in 2005) and 77 for New Zealand (33 in 2005). The usage of biventricular ICDs was 33% for Australia and 13% for New Zealand.

The Australian and New Zealand cardiac pacing and implantable cardioverter-defibrillator survey: calendar year 2005.

BACKGROUND: A pacemaker (PM) and implantable cardioverter-defibrillator (ICD) survey was undertaken in Australia (Au) and New Zealand (NZ) for 2005. RESULTS AND CONCLUSIONS: Compared to the 2001 survey, significant increases in implantation numbers were recorded. For 2005, the total new PMs implanted was 11,850 in Au (9498 in 2001) and 1134 in NZ (914 in 2001). The number of new PM implants per million population was 590 in Au (486 in 2001) and 275 in NZ (245 in 2001). Biventricular PMs were documented for the first time with 461 implants in Au and 16 in NZ. Pulse generator types were predominantly dual chamber with 73% in Au (70% in 2001) and 51% in NZ (54% in 2001). Pacing leads were overwhelmingly transvenous and bipolar with an increase in the use of active fixation leads in preference to tined leads. There was a marked increase in the use of ICDs with 2864 new implants in Au (956 in 2001) and 134 in NZ (86 in 2001). The new ICD implants per million population were 142 in Au (49 in 2001) and 33 in NZ (23 in 2001). ICDs were 35% biventricular in Au and 10% in NZ. The Au Northern Territory is included for the first time.

Pulmonary complications following major head and neck surgery with tracheostomy: a prospective, randomized, controlled trial of prophylactic antibiotics.

OBJECTIVE: To test the hypothesis that extended postoperative antibiotic cover would reduce the incidence of pulmonary complications in patients undergoing major head and neck surgery with tracheostomy. DESIGN: A prospective, randomized, controlled trial was carried out to determine the efficacy of an extended course (5 days) of intravenous amoxicillin-clavulanic acid in reducing the rate of atelectasis and pulmonary infections postoperatively. Other possible risk factors that might predispose to pulmonary complications were also evaluated. SETTING: Tertiary referral center for head and neck surgery. PATIENTS: Consecutive patients younger than 80 years with planned surgery for carcinoma of the oral cavity, pharynx, or larynx were enrolled. Patients with diabetes, those who had received antibiotics within 1 week before surgery, and those with preexisting pulmonary disease were excluded. INTERVENTION: Patients were randomly assigned no antibiotics or a 5-day course of intravenous amoxicillin-clavulanic acid postoperatively. MAIN OUTCOME MEASURES: The development of pulmonary complications (pulmonary infection or atelectasis). RESULTS: Eighty-six patients were enrolled; 73 patients met the criteria for analysis. Thirty-four (47%) developed pulmonary complications; 29 (40%) had a pulmonary infection. An extended course of antibiotics did not reduce the rate of pulmonary infections (P =.57). Positive risk factors for a pulmonary infection were presence of preoperative obstructive lung function and postoperative atelectasis. CONCLUSIONS: An extended course of antibiotics did not prevent the development of postoperative pulmonary infections in patients undergoing major head and neck surgery with tracheostomy. Poor pulmonary function and postoperative atelectasis emerged as significant risk factors for pulmonary infection.

The Australian and New Zealand cardiac pacing and implantable cardioverter-defibrillator survey: calendar year 2001.

AIM: A pacemaker (PM) and implantable cardioverter-defibrillator (ICD) survey was undertaken in Australia (Au) and New Zealand (NZ) for calendar year 2001. RESULTS AND CONCLUSIONS: Compared to the 1997 survey, significant increases in implantation numbers were recorded. For 2001, the total new PMs implanted was 9498 Au (6405 in 1997) and 914 NZ (823 in 1997). The number of new PM implants per million population was 486 Au (345 in 1997) and 245 NZ (228 in 1997). There were also significant increases in PM replacements between surveys with 1536 in Au (735 in 1997) and 195 in NZ (126 in 1997). Dual chamber implants were 71% Au (65% in 1997) and 56% NZ (55% in 1997). Pacing leads were overwhelmingly transvenous and bipolar with an increase in the use of active fixation leads in preference to tined leads, particularly in the atrium. There was a marked increase in the use of ICDs. The implants were 956 Au (449 in 1997) and 86 NZ (31 in 1997) with new implants per million population being 49 Au and 23 NZ. A breakdown of data for the six Au States and well as comparisons of similar surveys from other countries is presented.