One-Year Experience of Cardiac Devices Implantation in Baghdad Teaching Hospital and Review of Their Indications and Related Early Complications

Keywords: Pacemaker, Arrhythmia, Syncope


Background: Arrhythmias can cause a range of problems for patients, from palpitations and dizzy spells, to blackouts and sudden cardiac arrest. Cardiac rhythm management including device implantation is the treatment for special type of arrhythmias.
Objective: To evaluate the practice of trans-venous permanent devices (pacemaker single ventricle, biventricular and intra-cardiac defibrillator) implantation.
Methods: A group of 150 patients with different indications for permanent pacemaker and intra-cardiac defibrillator implantation who were referred to Baghdad Teaching Hospital - catheterization unit during the period from December 2016 to December 2017 were enrolled in this study. Case sheets of all patients were studied carefully and their indications for devices implantation were re-evaluated. The implantation procedures log were reviewed and short-term complications (within two weeks of the implantation) were studied.
Results: The mean age of the enrolled patients was 62 ±3 years. The most common presentation were dizziness (62%) syncope (36.6%) and the least common presentation was disturbed level of consciousness. Complete heart block was the most common ECG finding (30.6%). Left bundle branch block was (23.3%) and ventricular tachycardia was (8%). The indications for devices implantation were compatible with American 2012 guidelines for (single or bi ventricular pacing and intra-cardiac defibrillator implantation). The single ventricle lead pacemaker mode was (20.66%), while dual leads pacemaker mode was (36.66%). Defibrillator lead device was implanted in 49 patients (32.66%) and biventricular pacing implanted in 15 patient (10%). Total complications occurred in (2.6%) of the all procedures. Hypertension and ischemic heart diseases appeared to be the strongest associated factor (68.6%) in this study.
Conclusion: Dizziness and syncope were the main presentation. Hypertension and ischemic heart diseases are main associate factors, minimal complication were reported in the current study and most of them were transient.