Assessment of Trend, Indication, Complications, and Outcomes of Pacemaker Implantation in Adult Patients at Tertiary Hospital of Ethiopia: Retrospective Follow Up Study

Abstract

Sura Markos,1 Mohammed Nasir,2 Muluken Ahmed,3 Sintayehu Abebe,4 Mebratu Ayele Amogne,4 Demu Tesfaye,4 Tigist Seleshi Mekonnen,4 Yitagesu Getachew Getachew5 1Internal Medicine Department, Hawassa University, Hawassa, Ethiopia; 2Pediatrics Department, Hawassa University, Hawassa, Ethiopia; 3Pediatrics Department, Arba Minch University, Arba Minch, Ethiopia; 4Internal Medicine Department, Addis Ababa University, Addis Ababa, Ethiopia; 5Internal Medicine Department, Yekatit 12 Teaching Hospital, Addis Ababa, EthiopiaCorrespondence: Sura Markos, Internal Medicine Department, Hawassa University, Hawassa, Ethiopia, Email [email protected]: A pacemaker is a device implanted in the chest to help people with symptomatic bradycardia and life-threatening irregular rhythm. However, it is also associated with many complications. Therefore, this study evaluated pacemaker-related complications and factors associated with them, as there is little data on pacemaker-related complications in sub-Saharan Africa and Ethiopia.Methods: The study was conducted on 118 patients over 18 years old who had pacemakers implanted between 2017 and 2022 at Tikur Anbessa Comprehensive Specialized Hospital in Addis Ababa, Ethiopia who were reviewed by the authors from September 2022 to December 2022. Sociodemographic factors, clinical characteristics, and complications data were extracted using a structured questionnaire by retrospective review of patient records. The chi-square test or Fisher’s exact test was performed to evaluate factors associated with complications.Results: The median age of patients was 60.5 years (IQR = 15 years), with men accounting for 50.8% of patients. Hypertension was the most common comorbidity (64.2%). Symptomatic grade 3 AV block was the most common indication (78.8%) for pacemaker implantation. With a mean follow-up of 3.92 ± 1.94 years, 15.3% of patients had complications. Pneumothorax, pocket site infection, and lead dislodgement were the most common complications occurring in 2.54% of patients each. Patient age during surgery (p-value = 0.02), patient gender (p-value = 0.04), pacemaker implanting team (p-value = 0.01), and adherence to follow-up (p-value = 0.04) are related to pacemakers-related complications.Conclusion: Pacemaker implantation is associated with many complications. Pneumothorax, pacemaker pocket infection, and lead dislodgement were the most common complications. Patient age at pacemaker implantation, patient gender, pacemaker implanting team, and follow-up compliance were factors associated with pacemaker-related complications. Skill development through specialized training and compliance counseling may improve outcomes for patients who have complications related to pacemaker implanting team and poor adherence to follow.Keywords: pacemaker, pacemaker-related complications, associated factors

Keywords

• pacemaker
• pacemaker-related complications
• associated factors