Advertisement
Heart, Lung and Circulation

The Necessary Perils of Pacemaker Implantation in Young Individuals—Can We Do Better?

  • Juan Mundisugih
    Affiliations
    Department of Cardiology, Lyell McEwin Hospital, Adelaide, SA, Australia
    Search for articles by this author
  • Dian A. Munawar
    Affiliations
    Department of Cardiology, Lyell McEwin Hospital, Adelaide, SA, Australia

    Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia

    Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia
    Search for articles by this author
  • Rajiv Mahajan
    Correspondence
    Corresponding author at: Associate Professor Rajiv Mahajan, University of Adelaide Precinct, Lyell McEwin Hospital Haydown Road, Elizabeth Vale, SA 5112, Australia
    Affiliations
    Department of Cardiology, Lyell McEwin Hospital, Adelaide, SA, Australia

    Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
    Search for articles by this author
      In the last two decades, there has been an increase in the implantation of permanent pacemakers (PPMs) [
      • Greenspon A.J.
      • Patel J.D.
      • Lau E.
      • Ochoa J.A.
      • Frisch D.R.
      • Ho R.T.
      • et al.
      Trends in permanent pacemaker implantation in the United States from 1993 to 2009: increasing complexity of patients and procedures.
      ,
      • Zecchin M.
      • Torre M.
      • Carrani E.
      • Sampaolo L.
      • Ciminello E.
      • Ortis B.
      • et al.
      Seventeen-year trend (2001–2017) in pacemaker and implantable cardioverter-defibrillator utilization based on hospital discharge database data: an analysis by age groups.
      ,
      • Westaway S.
      • Nye E.
      • Gallagher C.
      • Tu S.J.
      • Clarke N.
      • Hanna-Rivero N.
      • et al.
      Trends in the use, complications, and costs of permanent pacemakers in Australia: a nationwide study from 2008 to 2017.
      ]. Unlike similarly developed countries, Australia has not yet reached a plateau in demand for pacemaker implants [
      • Westaway S.
      • Nye E.
      • Gallagher C.
      • Tu S.J.
      • Clarke N.
      • Hanna-Rivero N.
      • et al.
      Trends in the use, complications, and costs of permanent pacemakers in Australia: a nationwide study from 2008 to 2017.
      ]. Although the increase is driven by the ageing population, a rise in implantation of PPMs has been noted across all age groups. Acute complications from pacemaker implantation are well-recognised but the long-term implications of pacemaker implantation remain less well characterised, especially in the younger population. Although this age group only accounts for a small proportion of overall pacemaker insertion [
      • Zecchin M.
      • Torre M.
      • Carrani E.
      • Sampaolo L.
      • Ciminello E.
      • Ortis B.
      • et al.
      Seventeen-year trend (2001–2017) in pacemaker and implantable cardioverter-defibrillator utilization based on hospital discharge database data: an analysis by age groups.
      ,
      • Dębski M.
      • Ulman M.
      • Ząbek A.
      • Boczar K.
      • Haberka K.
      • Kuniewicz M.
      • et al.
      Association of selected factors with long-term prognosis and mortality after dual-chamber pacemaker implant.
      ], their expected longevity predisposes them to complications [
      • Westaway S.
      • Nye E.
      • Gallagher C.
      • Tu S.J.
      • Clarke N.
      • Hanna-Rivero N.
      • et al.
      Trends in the use, complications, and costs of permanent pacemakers in Australia: a nationwide study from 2008 to 2017.
      ,
      • Bradshaw P.J.
      • Stobie P.
      • Knuiman M.W.
      • Briffa T.G.
      • Hobbs M.S.T.
      Trends in the incidence and prevalence of cardiac pacemaker insertions in an ageing population.
      ,
      • Healey J.S.
      • Toff W.D.
      • Lamas G.A.
      • Andersen H.R.
      • Thorpe K.E.
      • Ellenbogen K.A.
      • et al.
      Cardiovascular outcomes with atrial-based pacing compared with ventricular pacing: meta-analysis of randomized trials, using individual patient data.
      ,
      • de Vries L.M.
      • Dijk W.A.
      • Hooijschuur C.A.M.
      • Leening M.J.G.
      • Stricker B.H.C.
      • van Hemel N.M.
      Utilisation of cardiac pacemakers over a 20-year period: results from a nationwide pacemaker registry.
      ,
      • Kirkfeldt R.E.
      • Johansen J.B.
      • Nohr E.A.
      • Jørgensen O.D.
      • Nielsen J.C.
      Complications after cardiac implantable electronic device implantations: an analysis of a complete, nationwide cohort in Denmark.
      ].

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Heart, Lung and Circulation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Greenspon A.J.
        • Patel J.D.
        • Lau E.
        • Ochoa J.A.
        • Frisch D.R.
        • Ho R.T.
        • et al.
        Trends in permanent pacemaker implantation in the United States from 1993 to 2009: increasing complexity of patients and procedures.
        J Am Coll Cardiol. 2012; 60: 1540-1545
        • Zecchin M.
        • Torre M.
        • Carrani E.
        • Sampaolo L.
        • Ciminello E.
        • Ortis B.
        • et al.
        Seventeen-year trend (2001–2017) in pacemaker and implantable cardioverter-defibrillator utilization based on hospital discharge database data: an analysis by age groups.
        Eur J Intern Med. 2021; 84: 38-45
        • Westaway S.
        • Nye E.
        • Gallagher C.
        • Tu S.J.
        • Clarke N.
        • Hanna-Rivero N.
        • et al.
        Trends in the use, complications, and costs of permanent pacemakers in Australia: a nationwide study from 2008 to 2017.
        Pacing Clin Electrophysiol. 2021; 44: 266-273
        • Dębski M.
        • Ulman M.
        • Ząbek A.
        • Boczar K.
        • Haberka K.
        • Kuniewicz M.
        • et al.
        Association of selected factors with long-term prognosis and mortality after dual-chamber pacemaker implant.
        Cardiol J. 2019; 26: 717-726
        • Bradshaw P.J.
        • Stobie P.
        • Knuiman M.W.
        • Briffa T.G.
        • Hobbs M.S.T.
        Trends in the incidence and prevalence of cardiac pacemaker insertions in an ageing population.
        Open Heart. 2014; 1e000177
        • Healey J.S.
        • Toff W.D.
        • Lamas G.A.
        • Andersen H.R.
        • Thorpe K.E.
        • Ellenbogen K.A.
        • et al.
        Cardiovascular outcomes with atrial-based pacing compared with ventricular pacing: meta-analysis of randomized trials, using individual patient data.
        Circulation. 2006; 114: 11-17
        • de Vries L.M.
        • Dijk W.A.
        • Hooijschuur C.A.M.
        • Leening M.J.G.
        • Stricker B.H.C.
        • van Hemel N.M.
        Utilisation of cardiac pacemakers over a 20-year period: results from a nationwide pacemaker registry.
        Neth Heart J. 2017; 25: 47-55
        • Kirkfeldt R.E.
        • Johansen J.B.
        • Nohr E.A.
        • Jørgensen O.D.
        • Nielsen J.C.
        Complications after cardiac implantable electronic device implantations: an analysis of a complete, nationwide cohort in Denmark.
        Eur Heart J. 2013; 35: 1186-1194
        • Shirwaiker A.
        • William J.
        • Mariani J.A.
        • Kistler P.M.
        • Patel H.C.
        • Voskoboinik A.
        Long-term implications of pacemaker insertion in younger adults: a single centre experience.
        Heart Lung Circ. 2022; 31: 993-998
        • Munawar D.A.
        • Mahajan R.
        • Agbaedeng T.A.
        • Thiyagarajah A.
        • Twomey D.J.
        • Khokhar K.
        • et al.
        Implication of ventricular pacing burden and atrial pacing therapies on the progression of atrial fibrillation: a systematic review and meta-analysis of randomized controlled trials.
        Heart Rhythm. 2019; 16: 1204-1214
        • Mahajan R.
        • Perera T.
        • Elliott A.D.
        • Twomey D.J.
        • Kumar S.
        • Munwar D.A.
        • et al.
        Subclinical device-detected atrial fibrillation and stroke risk: a systematic review and meta-analysis.
        Eur Heart J. 2018; 39: 1407-1415
        • Poole J.E.
        • Gleva M.J.
        • Mela T.
        • Chung M.K.
        • Uslan D.Z.
        • Borge R.
        • et al.
        Complication rates associated with pacemaker or implantable cardioverter-defibrillator generator replacements and upgrade procedures: results from the REPLACE registry.
        Circulation. 2010; 122: 1553-1561
        • Eberhardt F.
        • Bode F.
        • Bonnemeier H.
        • Boguschewski F.
        • Schlei M.
        • Peters W.
        • et al.
        Long term complications in single and dual chamber pacing are influenced by surgical experience and patient morbidity.
        Heart. 2005; 91: 500
        • Udo E.O.
        • Zuithoff N.P.A.
        • van Hemel N.M.
        • de Cock C.C.
        • Hendriks T.
        • Doevendans P.A.
        • et al.
        Incidence and predictors of short- and long-term complications in pacemaker therapy: the FOLLOWPACE study.
        Heart Rhythm. 2012; 9: 728-735
        • Munawar D.A.
        • Mahajan R.
        • Linz D.
        • Wong G.R.
        • Khokhar K.B.
        • Thiyagarajah A.
        • et al.
        Predicted longevity of contemporary cardiac implantable electronic devices: a call for industry-wide "standardized" reporting.
        Heart Rhythm. 2018; 15: 1756-1763

      Linked Article