RESUMO
UNLABELLED: The complications of permanent pacemaker implant, are found among 6%-9% of patients. Different factors are related. OBJECTIVES: We evaluated the complications related with pacemaker implants and which are the independent risk factors associated with them. METHODS: Descriptive analysis, type case-controls, retrospective and prospective, including 743 consecutive patients, between January 2007 and April 2008. RESULTS: Age: 73.83 ± 12 years, 63.9% male. 43% of the patients had some degree of structural cardiopathy. There were no deaths related to pacemaker implants. Implant procedure-related complications were observed in 57 patients (7.67%), requiring a surgical intervention in 34 patients (4.57%). The most serious complications included one device-related infective endocarditis (0.13%), the entire device system was extracted, and one pneumothorax following subclavian vein puncture with insertion of a chest tube. In the multivariate analysis, low level of operator experience and preimplant heart failure were independent predictors for complications. CONCLUSIONS: In this consecutive series of patients with permanent pacemaker implant, there was a low rate of complications, similar to the reported international series. A low level of operator experience and preimplant heart failure were related.
Assuntos
Marca-Passo Artificial/efeitos adversos , Idoso , Competência Clínica , Feminino , Humanos , Masculino , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Prevalência , Estudos Prospectivos , Estudos Retrospectivos , Fatores de RiscoRESUMO
La frecuencia de complicaciones relacionadas al implante de marcapasos, es variable y se encuentra entre 6% a 9 %, y existen diferentes factores relacionados con las mismas. Objetivos: Evaluar las distintas complicaciones relacionadas con el implante de marcapasos y determinar cuáles son los factores de riesgo independientes que las predisponen. Métodos: Análisis descriptivo, tipo casos-controles, retrospectivo y prospectivo, correspondiente a 743 consecutivos, con implante de marcapasos definitivo, entre enero de 2007 y abril de 2008. Resultados: Edad de 73.83 ± 12 años, 63.9% varones. Los pacientes con algún grado de cardiopatía estructural representaron 43%. No hubo muertes relacionadas al implante de marcapasos. Tuvieron complicaciones relacionadas con el implante 57 pacientes (7.67%); 34 casos (4.57%), requirieron de una re-intervención quirúrgica. Hubo complicaciones graves: un paciente presentó endocarditis infecciosa (0.13%) que motivó la extracción del dispositivo y otro paciente, luego de la punción venosa subclavia, presentó neumotórax con necesidad de drenaje pleural (0.13%). En el análisis multivariado, las variables independientes relacionadas fueron: un operador poco experimentado y la presencia de insuficiencia cardiaca previa al implante. Conclusiones: En esta serie consecutiva de pacientes con implante de marcapasos definitivo, la incidencia de complicaciones se correlacionó con 1) operador con poca experiencia y 2) la presencia de insuficiencia cardiaca previa al implante, se relacionaron con las mismas.
The complications of permanent pacemaker implant, are found among 6%-9% of patients. Different factors are related. Objectives: We evaluated the complications related with pacemaker implants and which are the independent risk factors associated with them. Methods: Descriptive analysis, type case-controls, retrospective and prospective, including 743 consecutive patients, between January 2007 and April 2008. Results: Age: 73.83 ± 12 years, 63.9% male. 43% of the patients had some degree of structural cardiopathy. There were no deaths related to pacemaker implants. Implant procedure-related complications were observed in 57 patients (7.67%), requiring a surgical intervention in 34 patients (4.57%). The most serious complications included one device-related infective endocarditis (0.13%), the entire device system was extracted, and one pneumothorax following subclavian vein puncture with insertion of a chest tube. In the multivariate analysis, low level of operator experience and preimplant heart failure were independent predictors for complications. Conclusions: In this consecutive series of patients with permanent pacemaker implant, there was a low rate of complications, similar to the reported international series. A low level of operator experience and preimplant heart failure were related.