Kiviniemi M S, Pirnes M A, Eränen H J, Kettunen R V, Hartikainen J E
Department of Medicine, Kuopio University Hospital, Finland.
Pacing Clin Electrophysiol. 1999 May;22(5):711-20. doi: 10.1111/j.1540-8159.1999.tb00534.x.
This study evaluates complications related to permanent endocardial pacing in the era of modern pacemaker therapy. There is only limited information available about the complications related to modern cardiac pacing. Most of the existing data are based on the 1970s and are no longer valid for current practice. The recent reports on pacemaker complications are focused on some specific complication or are restricted to early complications. Thus, there are no reports available providing a comprehensive view of complications related to modern cardiac pacing. Four hundred forty-six patients, who received permanent endocardial pacemakers between January 1990 and December 1995 at Kuopio University Hospital, were reviewed retrospectively using patient records. Attention was paid to the occurrence of any complication during the implantation or follow-up. An early complication was detected in 6.7%, and 4.9% of patients were treated invasively due to the early complication. Late complication developed in 7.2% and reoperation was required in 6.3% of the patients. Complications related to the implantation procedure occurred in 3.1%. Inadequate capture or sensing was observed in 7.4% of the patients. Pacemaker infection was detected in 1.8% and erosion in 0.9% of the patients. An AV block developed in 3.6% (1.6%/year) patients who received an AAI(R)-pacemaker due to sick sinus syndrome. There was no mortality attributable to pacemaker therapy. A great majority (68%) of the complications occurred within the first 3 months after the implantation. Complications associated to modern permanent endocardial pacemaker therapy are not infrequent. Eleven percent of patients needed an invasive procedure due to an early or late complication.
本研究评估了现代起搏器治疗时代与永久性心内膜起搏相关的并发症。关于现代心脏起搏相关并发症的可用信息有限。现有的大多数数据基于20世纪70年代，对当前实践已不再有效。最近关于起搏器并发症的报告集中在某些特定并发症或仅限于早期并发症。因此，没有报告能全面呈现与现代心脏起搏相关的并发症情况。对1990年1月至1995年12月在库奥皮奥大学医院接受永久性心内膜起搏器植入的446例患者，利用患者记录进行了回顾性研究。重点关注植入或随访期间任何并发症的发生情况。6.7%的患者出现早期并发症，4.9%的患者因早期并发症接受了侵入性治疗。7.2%的患者出现晚期并发症，6.3%的患者需要再次手术。与植入手术相关的并发症发生率为3.1%。7.4%的患者出现夺获或感知不足。1.8%的患者检测到起搏器感染，0.9%的患者出现起搏器侵蚀。因病态窦房结综合征接受AAI(R)型起搏器植入的患者中，3.6%（每年1.6%）发生了房室传导阻滞。起搏器治疗未导致死亡。绝大多数（68%）并发症发生在植入后的前3个月内。与现代永久性心内膜起搏治疗相关的并发症并不少见。11%的患者因早期或晚期并发症需要进行侵入性操作。
