Pacemaker complications in the Early Period Post implantation (Preprint)

BACKGROUND Background: Over the past few years, cardiac pacemaker technology has advanced significantly, moving from basic single-chamber devices to complex multi-chamber systems. This evolution creates difficulties regarding mechanical and therapeutic issues. OBJECTIVE Aim: to assess the complications of permanent pacemaker implantation in the intraoperative and early postoperative period in all patients undergoing pacemaker implantation for the first time. METHODS Patients and Methods: This is a prospective study conducted at Shaheed Al-Mihrab Cardiac Center from April 2022 to December 2024 including 108 patients. All patients had permanent pacemaker implant for the first time. The patients’ medical history, demographic parameters and pacemaker device details were documented and complications were recorded. All the procedures were done under local anesthesia through subclavian vein approach. RESULTS Results: Single chamber pacemakers were implanted in 41 patient 37.96%, while dual leads pacemakers were implanted in 67 patient 62.04%. Intraoperative complications were relatively rare including subclavian artery puncture without significant sequelae in 5 patients 4.63% and pneumothorax in 3 patients 2.78%. There is no important variation in the incidence of pneumothorax and arterial puncture between dual leads and single lead devices. Redo procedure was required in 12 (11.1%) patients and there is no significant difference in the redo procedural rate between single chamber 4.63% and dual chamber pacemakers 5.56%. Lead dislodgement was the most common cause of redo procedure. Re-operation for pocket infection occurs in 4 patients 3.7%. Rare complications that do not require redo operation occurred in 9 patients including superficial infection 4.63% and under-sensing 2.78%. CONCLUSIONS Conclusion: Permanent pacemaker device implantation is considered a relatively low risk operation in specialized center. Regarding the rate of complications, no significant difference reported between dual leads and single leads pacemakers. Lead dislodgement was the main cause for redo operation which occurs mainly in the atrial leads. CLINICALTRIAL This research was conducted after obtaining the required official permits from Shaheed Al-Mihrab Cardiac Center. An informed written consent was obtained from all participants in this study. They were provided with information regarding the nature of the study. The participants were reassured about strict confidentiality of any data obtained and that the study findings would be utilized for research purposes. Throughout the study, strict adherence to the ethical principles outlined in the Declaration of Helsinki, was maintained.