Re-hospitalisations for complications and mortality following pacemaker implantation: a retrospective cohort study in an older population.

INTRODUCTION: A large number of older people receive pacemakers each year but broad population based studies that describe complications following pacemaker implantation in this population are lacking.

METHODS: We conducted a retrospective cohort study using data from the Australian Government Department of Veterans' Affairs database. The cohort consisted of patients who received a pacemaker from 2005 to 2014. The outcomes were subsequent re-hospitalisations for infections, procedure related complications, thromboembolism, cardiovascular events (heart failure, myocardial infarction, atrial fibrillation) and re-operation of pacemaker, and mortality.

RESULTS: There were 10,883 pacemakers recipients, the median age was 86 years (interquartile range 83-89), 61% were males and 74% received a dual chamber pacemaker. Within 90 days post discharge, re-hospitalisations were occasioned by pacemaker infection in 0.5%, device related complications in 1.5%, cerebral infarction in 0.7%, and heart failure in 6% of single chamber pacemaker recipients. In dual chamber pacemaker recipients re-hospitalisations were occasioned by pacemaker infection in 0.4%, septicaemia in 0.4%, device related complications in 1.2%, cerebral infarction in 0.3%, and heart failure in 3%. Re-hospitalisations for pacemaker adjustment occurred in 1.5% of patients. The 90-day post discharge mortality was 5% and 3% in patients with single and dual chamber pacemaker respectively.

CONCLUSION: Re-hospitalisations for infection, procedure related complications or thromboembolism occurred in 1-2% of patients within 90 days post discharge, while 10% of single chamber and 7% of dual chamber recipients experienced a re-hospitalisation for a cardiovascular event.