Risk factors concerning complications following permanent pacemaker implantation for patients on antithrombotic therapy: a cohort study.

The objective of this study was to identify the complications and associated factors presented by patients after pacemaker implantation, according to a regimen of antithrombotic therapy or without it. This is an analytical observational study on a prospective cohort of 310 consecutive patients with a permanent pacemaker implanted, included from January 1 to December 31, 2014 from 1 single center. The follow-up was conducted on 310 patients for 6 months. 239 patients (77%) received antithrombotic therapy at the time of the pacemaker implantation. 20.8% of complications are presented in patients without anticoagulant therapy, 80.8% of them being minor ones. In the case of patients with anticoagulant therapy, 30.3% of the complications are major ones. Factors associated with major complications were contusion (OR 2; 95% CI 1 to 3.8; p=0.049), and minor complications, arm immobilization >24 hours (p=<0.001) and contusion (p=0.002). This study found an increase in the overall risk and complications that can occur when implanting a permanent pacemaker in patients with antithrombotic therapy based on the time of immobilization and contusions after the implantation.

Safety of Permanent Pacemaker Implantation: A Prospective Study.

Although pacemaker implantation is considered to be low risk, it is not exempt from complications and technical failures during the procedure, both in the short and long term, and the complications that such patients may present remain unknown. The aim has been to analyze the complication rates associated with permanent pacing and to identify if these differ between patients with or without previous antithrombotic therapy. We used a prospective, single center, observational study of 310 adult patients with indications of permanent pacing. They were hospitalized from 1 January to 31 December 2014 and followed up for 6 months after the pacemaker implant. The participants were distributed into two groups according to the antithrombotic therapy prior to the implant. The most frequent major complications were pneumothorax (3.87%) and lead dislodgement (8.39%), while superficial phlebitis (12.90%) and uncomplicated hematomas (22.58%) were presented as the most recurrent minor complications. Hematomas were the most frequent minor complication in the antithrombotic therapy cohort, and shoulder pain was reported as the most recurrent minor complication in the non-exposed group. Finding out about complications in pacemaker implants enables a complete view of the process, and hence the prioritization of actions aimed at improving safety and reducing associated risks.