Clinical profiles of patients undergoing permanent pacemaker implantation in a tertiary care hospital in India
DOI:
https://doi.org/10.18203/2320-6012.ijrms20240209Keywords:
Atrioventricular block, Permanent pacemaker implantationAbstract
Background: Despite an increase in the number of permanent pacemaker implantations in India over the last few decades, there are no systematic nationwide database recording the rate of implantation of permanent pacemaker, clinical conditions or types of pacemakers used for PPM implantation in India.
Methods: A total of 5341 patients, admitted in the department of cardiology, Institute of Post Graduate Medical Education and Research, West Bengal, India from April, 2019 to August 2023 and received a permanent pacemaker were included in the study. Objective of the study was to provide information about the clinical profile and indications of patients receiving permanent pacemaker implantation (PPI).
Results: Most (67%) of the recipients among the study population were males. The mean (± SD) age of patients in the present cohort was 63.59±11.82 years. The most frequent type of pacemaker used in this institution was VVIR (86.2%). The mean impedance for DDDR type pacemakers was 599.7±109.19 (range =416-1074) for ventricle and 915.9±116.2 (range =525-1240) for the atrium, while the threshold of DDDR type was 0.5±0.3 (range =0.1 -3) for ventricles and 0.3±0.2 (range =0.1-1.3) for the atrium. For VVIR type of pacemakers, the impedance for ventricles was 918.5±131.1 (range =120-1620), while the threshold for ventricle was 0.3±0.2 (range =0.1-2.2). The commonest indication of pacemakers were AV blocks (69%), of which the commonest was complete heart block (59.7%).
Conclusions: In conclusion, male population were implanted with a higher number of pacemakers than females. No difference in age was noted among males and females in terms of the age of implantation. Use of single chamber VVIR types were higher than the dual chamber due to the pattern of government supply of pacemakers. Most common indication for pacemaker implantation was degenerative complete heart block.
References
Morgan JM. Basics of cardiac pacing: selection and mode choice. Heart. 2006;92(6):850-4.
Dhungana M, Sherpa K, Raut R, Joshi S, Bajracharya P, Sharma M, et al. Trends and Profile of Permanent Pacemaker Implantation in Nepal. Experience From Tertiary Cardiac Center (SGNHC) From 2001 to 2020. Nepal Heart J. 2021;18(1):29-32.
Mond HG, Proclemer A. The 11th world survey of cardiac pacing and implantable cardioverter-defibrillators: calendar year 2009-a world society of Arrhythmia’s project. Pac Clin Electrophysiol. 2011;34(8):1013-27
Jain M, Kiyawat P, Kiyawat S. Clinical profiles of patients undergoing pacemaker implantation in India. Hypertension. 2007;244:78-20.
Kumar B, Prakash J, Kumari S, Manjunath CN. Trends in permanent pacemaker implantation in Indian population: a single centre experience. J Clin Diagn Res. 2018;12(12).
Epstein, AE, DiMarco JP, Ellenbogen KA, Mark Estes NA, Freedman RA, Gettes LS, Gillinov AM, et al. “ACC/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices) developed in collaboration with the American Association for Thoracic Surgery and Society of Thoracic Surgeons.” J Am Coll Cardiol. 2008;51(21):2085-105.
Dêbski M, Ulman M, Z¥ Bek A, Haberka K, Lelakowski J, Ma£ ecka B. Gender differences in dual-chamber pacemaker implantation indications and long-term outcomes. Acta Cardiologica. 2016;71(1):41-5..
Deshmukh PP, Bhedodkar S, Rajput AS, Singh M, Namdeo T, Sarwle S, et al. Evaluation of clinical characteristics and outcomes of patients undergoing pacemaker implantation in Western Indian state of Maharashtra. Int J Sci Res. 2020;9(10):1430-4.
Styliadis IH, Mantziari AP, Gouzoumas NI, Vassilikos VP, Paraskevaidis SA, Mochlas ST, et al. Indications for permanent pacing and pacing mode prescription from 1989 to 2006. Experience of a single academic centre in Northern Greece. Hellenic J Cardiol. 2008;49:155-62.
Shenthar J, Bohra S, Jetley V, Vora A, Lokhandwala Y, Nabar A, et al. A survey of cardiac implantable electronic device implantation in India: By Indian Society of Electrocardiology and Indian Heart Rhythm Society. Indian Heart J. 2016;68(1):68-71.
Jha S, Acharya SM, Pahari A. Cardiac pacing at TU Teaching Hospital-Changing perspective. J Inst Med. 2007;20(1).
Thapa S, Gajurel RM, Poudel CM, Shrestha H, Thapa S, Devkota S, et al. Study of clinical profile and indications of Permanent Pacemaker Insertion in Nepali population presenting to tertiary care centre in Nepal. Nepal Heart J. 2019;16(2):47-52.
Brady PA, Shen WK, Neubauer SA, Hammill SC, Hodge DO, Hayes DL. Pacing mode and long-term survival in elderly patients with congestive heart failure: 1980-1985. J Intervent Cardiac Electrophysiol. 1997;1(3):193-201.
Larsen PD, Kerr AJ, Hood M, Harding SA, Hooks D, Heaven D, et al J. Pacemaker use in New Zealand–data from the New Zealand implanted cardiac device registry (ANZACS-QI 15). Heart Lung Circul. 2017;26(3):235-9.
Gadler F, Valzania C, Linde C. Current use of implantable electrical devices in Sweden: data from the Swedish pacemaker and implantable cardioverter-defibrillator registry. EP Europace. 2014;17(1):69-77.
