Impact of early (<7 days) pacemaker implantation after cardiac surgery on long‐term pacemaker dependency. Issue 6 (24th May 2021)

• Record Type: Journal Article
• Authors: Badoz, Marc; Favoulet, Baptiste; Serzian, Guillaume; Ecarnot, Fiona; Guillon, Benoit; Chopard, Romain; Meneveau, Nicolas
• Is Part Of: Pacing and clinical electrophysiology. Volume 44:Issue 6(2021)
• Page Start: 1018
• Page End: 1026
• Publication Date: 2021-05-24
• Subjects: cardiac surgery -- early implantation -- pacemaker dependency -- permanent pacemaker -- temporary epicardial pacing; Cardiac pacing -- Periodicals; Electrophysiology -- Periodicals; 617.4120645
• DOI: 10.1111/pace.14260
• Languages: English
• ISSNs: 0147-8389

Abstract

Abstract: Objective: We aimed to investigate pacemaker dependency after at least 1 year in patients with early (&lt;7 days) implantation, compared to those who received a pacemaker ≥7 days after cardiac surgery. Secondary endpoints were length of hospital stay and in‐hospital complications. Methods: Retrospective analysis of 108 consecutive patients who received a pacemaker after cardiac surgery between 06/2012 and 06/2018. Characteristics and outcomes were compared between patients with early (&lt;7 days) and late (≥7 days) implantation. Patients were followed up with evaluation of pacemaker dependency between April and June 2019. We identified predictors of dependency by logistic regression. Results: In total, 63.9% were men, average age 71.9 ± 11.8 years; 32 (29.6%) had early implantation, and 76 (70.4%) late implantation. After a median 3.2 years [IQR 1.9, 4.5] of follow‐up, 30 patients (27.8%) had died, and there was no difference in pacemaker dependency among survivors (66.7% vs. 46.5%, early vs. late respectively, p = .15). Patients in the early group had a shorter length of stay (11.5 [9.0, 14.0] vs. 15.0 [11.5, 20] days, p = .002) and less often had new‐onset atrial fibrillation (AF) post‐surgery (22.7% vs. 47.8%, p = .05). The only significant predictor of dependency was aortic valve replacement surgery (OR = 4.70, 95% CI [1.36 to 16.24]). Conclusion: Early implantation of a permanent pacemaker (&lt;7 days after cardiac surgery) does not impact on the proportion of patients with long‐term (&gt;12 months) pacemaker dependency, but is associated with shorter length of stay and less frequent new‐onset AF. These findings warrant prospective confirmation in randomized trials.