Department of Cardiology, Helsinki University Central Hospital, Haartmaninkatu 4, PO Box 340, 00029 HUS Helsinki, Finland.
Europace. 2010 Jan;12(1):103-8. doi: 10.1093/europace/eup361.
The aim of this study was to evaluate the current short-term (<3 months) complication rate related to cardiac rhythm management (CRM) device implantations.
We analysed data of the complications related to all CRM device implantations during 1 year (2006) in a tertiary referral university hospital. In 567 device implantations, pacing system upgrade procedures, or lead revisions, 78 complications occurred in 69 (12.2%) patients. Lead dislodgement, pocket haematoma or bleeding, pneumothorax, and infection were the most common accounting for >80% of all complications. The complication rate was more than twice as high in bradycardia pacemaker (PM) implantations performed by cardiology trainees (17.4%) than by experienced cardiologists (7.7%, P = 0.001). When performed by experienced cardiologists, the complication rate was not higher in implantations of more complex devices compared with that of bradycardia PMs. Fifty-two of the 69 patients needed additional surgical procedures. Altogether, the complications required 504 additional treatment days in hospital.
In conclusion, our retrospective 1-year single-centre survey shows that short-term implantation-related complications of contemporary device therapy are still frequent, occur much more frequently by trainees than by cardiologists, require a large number of additional surgical procedures, and substantially prolong the hospital stay.
本研究旨在评估心脏节律管理（CRM）装置植入术后近期（<3 个月）并发症的发生率。
我们分析了一家三级转诊大学医院 1 年内（2006 年）所有 CRM 装置植入相关并发症的数据。在 567 例装置植入术、起搏系统升级或导丝修订中，69 例（12.2%）患者发生了 78 例并发症。导线脱位、囊袋血肿或出血、气胸和感染是最常见的并发症，占所有并发症的 80%以上。由心脏病学受训者进行的缓慢性起搏器（PM）植入术的并发症发生率（17.4%）是经验丰富的心脏病专家（7.7%，P=0.001）的两倍多。当由经验丰富的心脏病专家进行操作时，与植入缓慢性 PM 相比，更复杂装置的植入并发症发生率并没有更高。69 例患者中有 52 例需要额外的手术治疗。总的来说，并发症导致 504 天额外住院治疗。
总之，我们回顾性的 1 年单中心调查显示，当代设备治疗的短期植入相关并发症仍然很常见，受训者比心脏病专家更频繁地发生，需要大量的额外手术治疗，并显著延长了住院时间。
