Trends and Profile of Permanent Pacemaker Implantation in  Nepal. Experience From Tertiary Cardiac Center (SGNHC) From  2001 to 2020.

Background and Aims: The number of pacemaker implantation is increasing at various centres of Nepal with increase in cardiac services. However, there are few data available regarding the pacemaker implantation in Nepal. This study intend to focus and study trends and profile of permanent pacemaker implantation (PPI) of 19 years experience at the referral tertiary cardiac center which will reflect intended objective of this study. Methods: This was a retrospective cross sectional study done at Shahid Gangalal National Heart Centre (SGNHC). The data of the patient who underwent PPI from 2001 November to 2020 August were reviewed. Patients data including age, sex, indication for pacing, mode of pacing, type of pacemaker implanted, implantation parameters such as lead impedence and threshold were recorded and analyzed. Results: A total of 3631 pacemaker implantation were performed at SGNHC from 2001 November to 2020 August. Among the total patients, 59.4% were male with mean age of 65.2±15.2 years. The most common indication was degenerative complete heart block (74.8%). Sick sinus syndrome (8.2%) was the second most common indication of pacing. The single chamber were implanted in 93.3% cases and dual chamber in 6.7% cases. VVIR was the most common mode of implantation in 93.1% cases, followed by DDDR (6.7%). AAIR (0.1%) and VDD in 0.1% cases. The total number of pacemaker implanted yearly in SGNHC has increased since the early year of implantation. During the early years most of the pacemakers were Single chamber (VVI) pacemaker and the implantation of dual chamber pacemaker increased gradually from year 2010 onwards. After the year 2010 the implantation of dual chamber pacemaker has increased significantly compared to prior to 2010 (p= 0.001). There were no gender differences in use of single chamber and dual chamber implantation during this period. (p value = 0.489). The dual chamber were implanted mostly in age group less than 65 year compared to more than 65 years (P value = 0.001). Conclusion: There is gradual increase in the number of pacemaker implantation yearly at SGNHC and since 2010 there is also increase in number of dual chamber pacemaker implantation though the single chamber pacemaker outnumbered the dual chamber implantation.

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

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20184906 ◽

2018 ◽

Vol 6 (12) ◽

pp. 4053

Author(s):

Sanjeev Bhat ◽

Dharminder Kumar ◽

Aditi Parimoo

Keyword(s):

Sinus Node ◽

Pacemaker Implantation ◽

Permanent Pacemaker ◽

Single Chamber ◽

Common Indication ◽

Permanent Pacemaker Implantation ◽

Pacing Mode ◽

Node Disease ◽

Sinus Node Disease ◽

Pacemaker Insertion

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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Gender Differences in Selection of Permanent Pacemaker Implantation at Manmohan Cardiothoracic Vascular and Transplant Centre, Kathmandu, Nepal

Journal of Nobel Medical College ◽

10.3126/jonmc.v4i1.13299 ◽

2015 ◽

Vol 4 (1) ◽

pp. 15-20

Author(s):

Jeevan Khanal ◽

Ratna Raj Poudyal ◽

Surya Devkota ◽

Sanjeev Thapa ◽

Amit Shrestha

Keyword(s):

Gender Differences ◽

Pacemaker Implantation ◽

Permanent Pacemaker ◽

Continuous Variables ◽

Dual Chamber ◽

Chi Square ◽

Single Chamber ◽

Permanent Pacemaker Implantation ◽

To Receive ◽

Selection Of

Background: Permanent pacemaker implantation is a minimally invasive surgical procedure in the management of patients with cardiac rhythm disturbances. Previous studies have reported gender differences in pacemaker selection. There is lack of evidences in selection of pacemaker mode with respect to gender in Nepal. Therefore, this study was performed to compare the frequency of implantation between men and women.Objectives: This study was performed to compare the frequency of implantation rate between men and women.Methods: The present study is based on all consecutive pacemaker implantations in a single centre between April 2014 and May 2015. A total of 116 patients were categorized into two cohorts according to the type of pacemaker implanted- single chamber or dual chamber. Data were presented as means ± standard deviation (SD) for continuous variables and as proportions for categorical variables. Comparison of continuous variables between the groups was made with independent Student’s t-test. For discrete variables distribution between groups were compared with Chi-square test.Results: The mean age (±SD) of total population at implant was 64.08 (± 15.09) years. Dual chamber units were implanted in 44 (37.93%) of patients, single chamber in 72 (62.06%). Only 14 women (31.81%) received dual chamber compared with 42 women (58.33%) who received single chamber (Chi-square=18, DF=1, P = 0.0084). Complete atrioventricular block was the commonest (56.03%) indication for permanent pacemaker insertion followed by sick sinus syndrome (33.62%), symptomatic high-grade AV block (11.20%). Hypertension (dual chamber 21.55%, single chamber 40.51%) was the most common comorbidity in both cohorts.Conclusions: Women were more likely to receive single chamber systems and less likely to receive dual chamber systems than men. Journal of Nobel College of Medicine Vol.4(1) 2015: 15-20

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Study of clinical profile and indications of Permanent Pacemaker Insertion in Nepali population presenting to tertiary care centre in Nepal

Nepalese Heart Journal ◽

10.3126/njh.v16i2.26317 ◽

2019 ◽

Vol 16 (2) ◽

pp. 47-52

Author(s):

Shovit Thapa ◽

Ratna Mani Gajurel ◽

Chandra Mani Poudel ◽

Hemant Shrestha ◽

Sanjeev Thapa ◽

...

Keyword(s):

Pacemaker Implantation ◽

Permanent Pacemaker ◽

Published Data ◽

Safe Procedure ◽

Dual Chamber ◽

Female Ratio ◽

Dual Chamber Pacemaker ◽

Common Indication ◽

Co Morbidity ◽

Pacemaker Insertion

Background and Aims: Although pacemaker implantation has been done regularly in Nepal for the last 20 years, there is no large scale published data of pacemaker implantations. Manmohan Cardiothoracic Vascular and Transplant Centre (MCVTC) have been providing uninterrupted permanent pacemaker implantation services since its inception. This led us an opportunity to report the data regarding permanent pacemaker implantations in MCVTC. Methods: Hospital records of all patients who had undergone PPI at MCVTC between Shrawan 2070 – Ashad 2075/ July 2013- June 2018 (5 years) were searched for and all available data were retrospectively analyzed. Results: A total of 277 cases underwent PPI at MCVTC in 5 years. Out of these 165 (59.5%) were male with male to female ratio of 1.47. The mean age was 65.82±16.10 years with 3 (1.1%) cases of <20 years of age and almost 70% of cases aged >60 years. Dual chamber units were implanted in 49 (17.7%) cases. Only 13 women (11.6%) received dual chamber pacemaker compared with 36 men (21.8%) (P = 0.029). The most common indication for PPI was complete atrioventricular block 165 (59.6%) followed by sick sinus syndrome 65 (23.5%). Hypertension 84 (30.3%) was the most common co morbidity present. Complication occurred in 5.4% of cases with wound infection as commonest complication and single mortality due to postoperative complications post-RV repair. Conclusion: Single chamber pacemaker was the most commonly used pacemaker. Dual chamber pacemaker was more common in younger patients. Complete heart block was the most common indication. Permanent pacemaker insertion was effective and relatively safe procedure in MCVTC with few complications.

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Permanent pacemaker implantation associated tricuspid regurgitation

Asian Cardiovascular and Thoracic Annals ◽

10.1177/0218492320971114 ◽

2020 ◽

pp. 021849232097111

Author(s):

Gul Zaman Khan Niazi ◽

Arslan Masood ◽

Nisar Ahmed ◽

Irfan Qadir ◽

Ammar Akhtar ◽

...

Keyword(s):

Body Mass Index ◽

Body Mass ◽

Tricuspid Regurgitation ◽

Pacemaker Implantation ◽

Potential Effect ◽

Permanent Pacemaker ◽

Dual Chamber ◽

Logistic Regression Models ◽

Permanent Pacemaker Implantation ◽

Number Of Patients

Objective To determine the prevalence of tricuspid regurgitation in patients with dual-chamber permanent pacemaker implantation. Methods This study included 153 patients undergoing permanent pacemaker implantation. All eligible candidates had baseline transthoracic echocardiography to rule out preexisting tricuspid regurgitation. Echocardiography across the tricuspid valve was repeated one month after permanent pacemaker implantation, and the frequency of significant tricuspid regurgitation was determined. The associations of potential effect modifiers (age, sex, height, body mass index categories, diabetes, and hypertension) with tricuspid regurgitation were assessed individually using simple and multivariable logistic regression models. Results After dual-chamber permanent pacemaker implantation, significant tricuspid regurgitation was present in 22 (15.8%) patients. Tricuspid regurgitation was significantly associated with body mass index >30 kg·m−2 (odds ratio = 32.84, 95% confidence interval: 1.26–853.82, p = 0.04). Conclusion Significant tricuspid regurgitation was present in substantial number of patients after dual-chamber pacemaker implantation and was independently associated with body mass index >30 kg·m−2.

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