Clinical Characteristics and Complications in Patients Undergoing Permanent Pacemaker Implantation

Background : Pacemakers are electronic impulse generators that are implanted to restore a regular heart rhythm in patients with symptomatic bradycardia. A large body of epidemiological data on permanent pacemaker implantation (PPI) originates from developed countries with minimal data from developing regions, especially sub-Saharan Africa. This study aims to describe patient demographics, clinical indications, short-term and long-term complications in patients undergoing PPI at the Charlotte Maxeke Johannesburg Academic Hospital, which is a large urban public teaching hospital in Johannesburg, South Africa. Methods : We retrospectively reviewed in-patient and out-patient medical records of consecutive patients who underwent index PPI over ten years (January 2009 to November 2018). Results : The study cohort comprised of 565 patients, of which 325 (57.52%) were female. The median age at first PPI was 71.8 [interquartile range: 61.7–78.8] years. The indications for pacemaker implantation were atrioventricular (AV) block in 417 (73.81%) and sinus node dysfunction in 114 (20.18%). A total of 40 (7.08%) patients experienced PPI-related complications. Lead dislodgement was the most common complication occurring in 16 (3.05%) patients. Females were 3.8 times more likely to experience a complication [odds ratio (OR): 3.80; 95% CI: 1.40–10.32, P = 0.009]. Conclusion : In this study, AV block was the most common indication for PPI, and the complication rate was found to be 7.08%. Furthermore, the risk of developing a complication was significantly higher in females.