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.