Key result
The reported rate of permanent pacemaker requirement following isolated, elective coronary artery bypass grafting is <1%, compared to <5% following aortic or mitral valve surgery.
Why the study?
Permanent pacemaker requirement after open-heart surgery causes significant morbidity and delayed recovery, and optimizing perioperative factors may reduce pacemaker rates and complications.
What are the rates and perioperative factors contributing to permanent pacemaker requirement following open-heart surgery?
What are the rates and perioperative factors contributing to permanent pacemaker requirement following open-heart surgery?
Permanent pacemaker requirement is a known complication post cardiac surgery, with rates varying by procedure type (<1% for CABG, <5% for valve surgery), and optimization of perioperative factors may reduce this risk.
Low PPM rates after CABG and valve surgery support ongoing arrhythmia monitoring; review leaves open precise perioperative risk stratification.
Cardiac arrhythmias and requirement for permanent pacemaker (PPM) post open-heart surgery are some of the complications that can contribute to significant morbidities postoperatively and delay in normal recovery if not treated promptly. The reported rate of a PPM following isolated, elective coronary artery bypass grafting is < 1%, while following aortic or mitral valve surgery it is reported to be < 5%. There are several perioperative factors that can contribute to the increased likelihood of PPM requirement including preoperative rhythm, severity and location of cardiac ischaemia, perioperative variables, and the cardiac procedures performed. Optimization of such factors can possibly lead to a lower rate of PPM and, therefore, a lower rate of complications. This literature review focuses on PPM following each procedural type and how to minimize it.
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Harky et al. (2021) conducted a review in Requirement for permanent pacemaker post open-heart surgery. Cardiac surgery was evaluated on Permanent pacemaker requirement. The reported rate of permanent pacemaker requirement following isolated, elective coronary artery bypass grafting is <1%, compared to <5% following aortic or mitral valve surgery.
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