A survey of cardiac implantable electronic device implantation in India: By Indian Society of Electrocardiology and Indian Heart Rhythm Society

Shenthar, Jayaprakash; Bohra, Shomu; Jetley, V; Vora, Amit; Lokhandwala, Yash; Nabar, Ashish; Naik, Ajay; Calambur, Narsimhan; Gupta, Shashi Bhushan

doi:10.1016/j.ihj.2015.06.037

Cited by 24 publications

(19 citation statements)

References 6 publications

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“…This is comparable to age distribution reported worldwide. 1,10 In USA, sinus node disease is the primary indication for pacemaker implantation in over 50% of patients. 20 Elderly patients with sick sinus syndrome or AV block are treated with pacemaker implantation.…”

Section: Discussionmentioning

confidence: 99%

“…In this report it showed that complete heart block (30.5%) was the most common indication for AV block and it was comparable to that reported in the earlier studies. 7,9,10 Harrigan RA et al, showed that temporary cardiac pacemaker is a life-saving procedure in the emergency department as it can definitely control the heart rate and provide adequate cardiac output in selected circumstances. 22 Among the 200 patients, 19.5% had temporary pacemaker implantation at the time of presentation in the emergency department prior to permanent pacemaker implantation.…”

Section: Discussionmentioning

confidence: 99%

“…11,12 The most common indications for a permanent pacemaker insertion are atrio-ventricular (AV) block and sick sinus syndrome with AV block responsible for 45-80% of pacemaker implantations in various studies. 9,10 Permanent pacemaker implantation is a minimally invasive procedure with a generally low complication rate mostly between 4-6.1%. 1,13,14 Complications are categorized into early and late.…”

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confidence: 99%

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Characteristics, indications and complications in patients undergoing permanent pacemaker implantation: a single centre study

2018

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Background: To determine the demographic details, indications, type of pacemakers and complications in patients undergoing the permanent pacemaker implantation.Methods: This was a single-center, retrospective study conducted in at a tertiary-care center in India. The records of 200 patients who had undergone implantation of permanent pacemakers in the period of May 2016 to April 2018 were reviewed.Results: Total 200 patients with mean age of 67 years were paced. Of these 120 (60%) were males. The mean duration of hospital stay was 6.5 days. Sinus node disease (105 patients, 52.5%) was the most common indication for permanent pacemaker insertion. Single chamber (VVIR) pacing mode (125 patients, 62.5%) was found to be the most common pacing mode used for pacemaker insertion. Among the 200 patients complications were observed in 8 patients (4%). Of these 8 patients, pneumothorax (4 patients, 2%) was found to be the most common complication for permanent pacemaker implantation followed by local site infection (1 patient, 0.5%). Only 1 patient (0.5%) died during the observation period of the study.Conclusions: Geriatric population with male predominance have observed to commonly undergo permanent pacemaker implantation. Sinus node disease in the elderly patients is the most common indication for cardiac pacing followed by atrioventricular block. Single chamber (VVIR) pacing mode is commonly used followed by dual chamber (DDDR) due to economic reasons in India. Pacemaker implantation is a relatively safe procedure with a low complication rate.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Characteristics, indications and complications in patients undergoing permanent pacemaker implantation: a single centre study

2018

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“…Furthermore, delaying pacemaker therapy for individuals with Class I indications has been shown to have negative clinical outcomes and result in poorer quality of life 8, 9. A recent survey of Cardiac Implantable Electronic Devices (CIEDs) across several centers in India reported that 80% of pacemaker implants were for bradycardia due to AV block, while only 20% were for SND 10 . This may highlight a preference for device implant to prevent death rather than improve quality of life in a relatively mild disease.…”

Section: Discussionmentioning

confidence: 99%

Under-utilization of pacemaker therapy for sinus node dysfunction – Real world data from South Asia

Narasimhan

Sanyal

Sethi

et al. 2017

Indian Heart Journal

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ObjectiveChronic symptomatic sinus node dysfunction (SND), the most common bradyarrhythmia, can be effectively managed by permanent cardiac pacing. Yet the care pathway and barriers to adoption of pacing therapy are not well understood – particularly in low volume implanting countries. The IMPROVE Brady study is a quality improvement initiative being conducted at centers in South Asia, Latin America, and Russia. We assessed the rates of SND diagnosis and pacemaker treatment for SND in the South Asia cohort.MethodsThe prospective study enrolled patients with heart rate of ≤50 beats per minute presenting with symptoms including syncope, dizziness, and/or dyspnea from ten centers in India and Bangladesh. Patients were followed to identify the proportion diagnosed with SND and subsequently treated with pacemaker therapy.ResultsA total of 508 patients meeting criteria were enrolled and followed on average for 8.3 ± 8.0 months. Patients were on average 58 years of age, 77% were male, and 91% had completed at least primary education. An SND diagnosis was made in 368 (72%) of patients, with the majority (80%) of diagnoses occurring within 1 month of enrollment. Of the patients with an SND diagnosis, 63 (17%) were treated with a pacemaker. Reasons for not receiving treatment were: subject refusal or deferred decision (45%), unaffordability (34%), physician determined – not-indicated (20%), and other (1%). Older age, female gender, history of hypertension, lower resting heart rate, and syncopal or pre-syncopal symptoms were associated with a higher probability of implant.ConclusionsIn a care pathway assessment for the diagnosis and treatment of symptomatic SND in South Asia only 1 in 6 patients received pacemaker indicated therapy, largely due to patient refusal and physician decision. Phase II of the study will be aimed to improve this treatment rate.

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“…In Indian scenario, it is at a mean of 25 implants /million population. 8 Strickland(2013) stated that, currently more than 3 million patients worldwide are with implanted permanent pacemaker. 9 Implantation of permanent pacemaker is only the first step in lifelong management of pacemakerpatients.…”

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confidence: 99%

Assessment of Effectiveness of Permanent Pacemaker Care Guidelines on Patient Activity and Adherence.

Sharma¹,

Shruti²,

SinghN³

et al. 2018

IJAR

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Objectives:The objectives of present study was to evaluate the effectiveness of Pacemaker Care Guidelines on pacemaker care practices adherence and performance in activities of daily living in patients with permanent pacemaker implantation. Material and methods: A quasi experimental design was considered for the present study. Total 100 samples were taken (50 in each control and experimental group) from cardiology units of Advance Cardiac Centre, PGIMER, Chandigarh by total enumeration sampling. Pacemaker Care Guidelines were developed and taught to experimental group with routine care and only routine care was given to control group. Tools used were sociodemographic profile, personal profile, clinical profile, Barthel Index for ADL and pacemaker care practices adherence checklist. Interview schedule and observation method was used for assessment of outcome variables at pre pacemaker implantation, 1 st ,5 th , 10 th post implantation day and after 1month and 2 month of pacemaker implantation. Results: The present study revealed that 94% patients in experimental group exhibited good adherence with pacemaker care practices as in control group average adherence was seen in 90% patients with statistically significant difference (p value <0.01). whereas ,in term of performance of activities of daily living, the Barthel score was 19.80±0.40 (range 18-20) in experimental group and in control group the Mean Barthel score was 16.43±1.92 (range 11-18) at 2 month of post Pacemaker implantation was seen with statistically significant improvement in ADL in experimental group (p value <0.05) Conclusion: In the present study, Pacemaker Care Guidelines were found effective in term of increasing adherence with pacemaker care practices and increasing independence in activities of daily living. Therefore such nursing guidelines should be taught to patients to improve pacemaker care and reduce the pacemaker related complications due to non-adherence.

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A survey of cardiac implantable electronic device implantation in India: By Indian Society of Electrocardiology and Indian Heart Rhythm Society

Abstract: A large proportion of CIED implants in India are PM for bradyarrhythmic indications, predominantly AV block. ICD's are implanted almost equally for primary and secondary prophylaxis. Most CRT devices are implanted for NYHA Class III. There is a male predominance for implantation of CIED.

Cited by 24 publications

References 6 publications

Characteristics, indications and complications in patients undergoing permanent pacemaker implantation: a single centre study

Characteristics, indications and complications in patients undergoing permanent pacemaker implantation: a single centre study

Under-utilization of pacemaker therapy for sinus node dysfunction – Real world data from South Asia

Assessment of Effectiveness of Permanent Pacemaker Care Guidelines on Patient Activity and Adherence.

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