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Europace 2002 4(2):107-112; doi:10.1053/eupc.2002.0234
© 2002 by European Society of Cardiology
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REGULAR ARTICLES

Quality assessment of pacemaker implantations in Denmark

M. Møller1, P. Arnsbo1, M. Asklund2, P. D. Christensen3, N. Gadsbøll4, J. H. Svendsen5, E. Klarholt6, K. E. Kleist7, P. T. Mortensen8, A. Pietersen9, E. H. Simonsen10, P. E. B. Thomsen11, T. Vesterlund12 and P. Wiggers13

1The Danish Pacemaker Register, Odense Universitetshospital Odense, Denmark; 2Kolding Sygehus Kolding, Denmark; 3Viborg Sygehus Viborg, Denmark; 4Bispebjerg Hospital København, Denmark; 5Rigshospitalet København, Denmark; 6Herning Centralsygehus Herning, Denmark; 7Dronning Ingrids Hospital Nuuk, Denmark; 8Skejby Sygehus Aarhus, Denmark; 9Hillerød Sygehus Hillerød, Denmark; 10Odense Universitetshospital Odense, Denmark; 11Amtssygehuset i Gentofte Hellerup, Denmark; 12Aalborg Sygehus Aalborg, Denmark; 13Haderslev Sygehus Haderslev, Denmark

Manuscript submitted 13 June 2001. Accepted after revision 27 January 2002.

Correspondence: Mogens Møller, MD, The Danish Pacemaker Register, Department of Cardiology, Odense University Hospital, Dk-5000 Odense C, Denmark. E-mail moller{at}pacemaker.dk

Key Words: Pacemaker, pacemaker leads, complications, quality standards


   Aims
Top
 Aims
Methods and Results
 Conclusions
 References
 
Quality assessment of therapeutic procedures is essential to insure a cost-effective health care system. Pacemaker implantation is a common procedure with more than 500 000 implantations world-wide per year, but the general complication rate is not well described. We studied procedure related complications for all implantations performed in an entire nation over a 3-year period.


   Methods and Results
Top
 Aims
 Methods and Results
Conclusions
 References
 
A prospective study of complications related to 99% of the 5648 primary pacemaker implantations performed in the 12 Danish pacemaker centres in 1997–1999 was carried out. Overall 76% of the patients received a physiological pacemaker system and 91% received the optimal pacing mode according to international guidelines. Perioperative complications requiring reoperation were: haematoma 0·3%, atrial lead related 1·9%, ventricular lead related 1·7%. Late complications requiring reoperation were: infection 0·2%, atrial lead related 1·3%, ventricular lead related 1·2%. The complication rate decreased over the study period, but overall the complication rate was higher than expected and showed considerable variation between centres.


   Conclusions
Top
 Aims
 Methods and Results
 Conclusions
References
 
Our results demonstrate that sensitive data such as complications related to pacemaker implantations can be collected on a national basis. We suggest that a reoperation rate higher than 3% for atrial as well as ventricular pacing electrodes in the individual implanting centre should cause the centre to evaluate carefully the procedure as well as the performance of the individual implanter.


   References
Top
 Aims
 Methods and Results
 Conclusions
 References
 
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[17] Møller M and Arnsbo P. Appraisal of pacing lead performance from the Danish Pacemaker Register. Pacing Clin Electrophysiol 1996; 19: 1327–1336.[CrossRef][Medline]

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