Outcomes of a 24/7 service for urgent permanent pacemaker implantation

Most of the complications associated with acute and symptomatic bradyarrhythmia (ASB) occur in the time from diagnosis to permanent pacemaker implantation (PPI). We aimed to evaluate the outcomes of an urgent 24/7 PPI service (PPI-24/7) for patients with ASB. A total of 664 patients undergoing first...

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Bibliographic Details
Published in:Revista española de cardiología (English ed.) 2024-11, Vol.77 (11), p.899-909
Main Authors: Jiménez-Candil, Javier, Oterino, Armando, Cruz Galbán, Alba, Hernández, Jesús, Moríñigo, José Luis, Sánchez García, Manuel, Sánchez, Pedro L.
Format: Article
Language:English
Subjects:
Bradicardia
Bradyarrhythmia
Marcapasos
Outcomes 24/7 service
Pacemaker
Prognosis
Pronóstico
Servicio permanente
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Summary:Most of the complications associated with acute and symptomatic bradyarrhythmia (ASB) occur in the time from diagnosis to permanent pacemaker implantation (PPI). We aimed to evaluate the outcomes of an urgent 24/7 PPI service (PPI-24/7) for patients with ASB. A total of 664 patients undergoing first-time PPI for ASB were prospectively assessed during 2 periods of identical length (18 months): 341 patients who underwent the procedure during working hours only (PPI-WH), and 323 patients who underwent the procedure after the implementation of the PPI-24/7 service. The primary safety endpoint was established as the cumulative 180-day incidence of complications related to the index arrhythmia and device implant. The primary efficacy endpoint was determined as the average number of hospital stays per patient. The PPI-24/7 period was associated with a significant shortening of the time from diagnosis to implantation (median [interquartile range]): 3hours [2-6] vs 16 [5-21]). The cumulative incidence of patients with complications at 180 days was lower in the PPI-24/7 period: 9% vs 17% (adjusted odds ratio, 0.5; P=.002), due to a significant reduction in preimplant complications: 2.5% vs 12% (P
ISSN:1885-5857
1885-5857
DOI:10.1016/j.rec.2024.03.003