Clinical profiles and outcomes of patients undergoing pacemaker implantation

Background: The insertion of a permanent cardiac pacemaker is today one of the most commonly performed interventions on the heart. Various hypotheses have been put forward to explain the high incidence of conduction system disorders in the eastern part of our country. We studied the clinical profiles and outcomes of patients undergoing pacemaker implantation at the Regional Institute of Medical Science Imphal, Manipur, India. Materials and Methods: Thirty-seven patients who satisfied the inclusion criteria and underwent pacemaker implantation were studied. Detailed evaluation was done for each patient. Electrocardiography (ECG), echocardiography, chest x-ray, lipid profile, and other routine investigations were carried out. Patients were followed up for 6 weeks for any acute complication of pacemaker implantation. Results: Of the 37 patients, 21 (57%) were male, and the mean age of the study group was 63.24 years. The indications for pacemaker implantation were atrioventricular (AV) block [in 24 (64.9%) patients], sick sinus syndrome (SSS) [10 (27.1%)], and trifascicular block [3 (4.5%)]. The most common presenting symptoms were syncope (in 59.9% of patients), lightheadedness (62.2%), palpitation (56.7%), and dyspnea (56.7%). Cardic arrhythmias were associated with hypertension (in 59.5% of patients), diabetes mellitus (21.6%), thyroid disease (16.2%), and coronary heart disease (CAD,13.5%). In 32.4% of the patients there were associated comorbid conditions. No further syncopal attack occurred following pacemaker implantation, and the other symptoms improved significantly. The complications observed were pneumothorax and pacemaker implant site wound exudation in one patient each. Conclusion: The major indications of pacemaker implantation were found to be complete heart block (CHB) and SSS. Pacemaker implantation is a lifesaving procedure and improves quality of life dramatically. Complications associated with pacemaker implantation are relatively low.