What is the clinical evidence from this study?

Study design: Observational. Population: Pacemaker implantation (n=1884). Intervention: DDD pacemaker implantation vs. VVI or VDD pacemaker implantation. Primary outcome: Complication rate.

What question did this study set out to answer?

To evaluate how patient morbidity, operator experience, and the choice of pacing system affect short- and long-term complication rates and operative duration following pacemaker implantation.

March 16, 2005HeartOpen Access

Long term complications in single and dual chamber pacing are influenced by surgical experience and patient morbidity

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Key result

DDD pacemaker implantation was associated with a higher complication rate (6.3%) compared to VVI (2.6%) or VDD (3.2%) systems, particularly among operators with low or medium experience.

Why the study?

Does DDD pacemaker implantation increase complication rates compared to VVI or VDD pacemakers in patients requiring pacing?

Key Points

To evaluate how patient morbidity, operator experience, and the choice of pacing system affect short- and long-term complication rates and operative duration following pacemaker implantation.
Retrospective analysis of 1884 patients who received VVI (n = 610), VDD (n = 371), or DDD devices (n = 903) between 1990 and 2001.
Patients were monitored over a follow up period of 64 (34) months to evaluate the influence of clinical risk factors, pacing system type, and operator experience level.
The overall complication rate was 4.5%, with 67% of complications occurring within the first three months post-implantation.
DDD pacemakers had a higher complication rate (6.3%) than VVI (2.6%) or VDD systems (3.2%), with excess complications occurring only among operators with low or medium experience.
Operation time and complication rates were significantly increased in patients with advanced age, reduced left ventricular function, and right ventricular dilatation.

Study Design

Type

Observational (n=1,884)

Structured PICO

Does DDD pacemaker implantation increase complication rates compared to VVI or VDD pacemakers in patients requiring pacing?

Population

1,884 patients who received VVI, VDD, or DDD pacemakers between 1990 and 2001, followed for a mean of 64 months.

Exposure

DDD pacemaker implantation

Comparator

VVI or VDD pacemaker implantation

Outcome

Short and long term complication rates and operation timesafety

Main Result

Absolute Event Rate: 6.3% vs 2.6%

DDD pacemaker implantation is associated with higher complication rates and longer operation times compared to VVI or VDD systems, especially when performed by less experienced operators.

Discussion

No takes yet. Share an insight, caveat, or question.

Implication

May favor simpler modes with less experienced operators; leaves open whether DDD risks are causal or modifiable in randomized settings.

Cite This Study

Frank Eberhardt (2005) conducted an observational in Pacemaker implantation (n=1,884). DDD pacemaker implantation vs. VVI or VDD pacemaker implantation was evaluated on Complication rate. DDD pacemaker implantation was associated with a higher complication rate (6.3%) compared to VVI (2.6%) or VDD (3.2%) systems, particularly among operators with low or medium experience.

synapsesocial.com/papers/6a96767696bab72bf50e26c8 https://doi.org/10.1136/hrt.2003.025411

View Full Paper

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Long term complications in single and dual chamber pacing are influenced by surgical experience and patient morbidity

Key Points

Study Design

Structured PICO

Main Result

Discussion

Implication

Cite This Study

Long term complications in single and dual chamber pacing are influenced by surgical experience and patient morbidity

Key Points

Study Design

Structured PICO

Main Result

Discussion

Implication

Cite This Study

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