Decade of permanent cardiac pacing in a tertiary care hospital of Northern India

Abstract

This study of 10 year review of pacing was undertaken to analyse the continuous rise in the incidence of pacing in this part of country. 532 patients implanted with permanent pacemakers were evaluated during this decade. The age of patients ranged from 6 to 85 years with majority of patients belonging to age group of 55 to 70 years and a male to female ratio of 2:1. The commonest presenting symptom was cardiac syncope seen in 76.50% followed by pre-syncope 31.50% .The indications for pacemaker implantation were complete heart block 48.12%, sick sinus syndrome 19.17%, symptomatic bifascicular block 12.96%, Mobitz type II 2 nd degree heart block 7.14%, permanent pacemaker dysfunction 5.85%, trifascicular block 5.63% and high degree AV block 1.13%. The commonest risk factors encountered in these patients were smoking 59.21%, followed by hypertension 26.32%, only 0.56% had no evidence of risk factor. The complications following pacemaker implantation were seen in 8.27%, 2.26% got lead displacement, 1.69% got wound infection, 1.69% got extrusion of generator. Other complications include lead fracture in 0.9%, premature battery failure 0.37% patients, high threshold in 0.19%, Pneumothorax in 0.19% and 0.5% got reimplantation because of generator expiry. Out of 532 patients paced permanently in the past decade, 458 patients followed regularly which revealed that majority of them were totally dependent upon the permanent pacemaker and had improved quality of Life.