Key result
Postoperative permanent cardiac pacing was required in 2.1% of patients undergoing open-heart surgery, with higher rates in valvular than coronary bypass surgery.
Why the study?
What is the incidence and what are the risk factors for requiring permanent cardiac pacing after open-heart surgery for acquired heart disease?
Observational (n=5,942)
What is the incidence and what are the risk factors for requiring permanent cardiac pacing after open-heart surgery for acquired heart disease?
Permanent cardiac pacing is required in 2.1% of patients after open-heart surgery, with higher rates in valvular surgery, and is associated with significant morbidity from lead-related complications.
Answers are grounded in this paper and cite their sources.
May inform preoperative counseling in valvular surgery; leaves open prospective validation of predictors and prevention.
Retrospective review of 5,942 patients who underwent open-heart surgery for acquired heart disease revealed that 123 patients (2.1%) required permanent cardiac pacing postoperatively; 4.6% of these underwent predominantly valvular surgery and 0.6% had coronary bypass. The most important factors appeared to be: 1) preoperative evidence of a conduction disorder; 2) advanced patient age; 3) dense calcium in the aortic annulus; 4) valvular surgery and, especially, tricuspid valve surgery; and 5) poor myocardial protection. Postoperative permanent pacing had a considerable impact on patient morbidity from maintenance operations; most complications were lead-related problems.
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Goldman et al. (1984) conducted an observational in Acquired heart disease requiring open-heart surgery (n=5,942). Open-heart surgery was evaluated on Requirement for permanent cardiac pacing postoperatively. Postoperative permanent cardiac pacing was required in 2.1% of patients undergoing open-heart surgery, with higher rates in valvular than coronary bypass surgery.
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