Abstract
An overnight stay after permanent pacemaker implantation has major cost implications for healthcare systems. Same day pacing could be effective in alleviating this. We evaluated our elective same day pacing practice to determine safety and cost-effectiveness. A total of 780 patients were scheduled for elective new permanent pacemaker implantation as a same day procedure at the University Hospital, North Staffordshire, from April 2001 to December 2006. The mean age +/- SEM of the cohort was 73.8 +/- 0.4 years (464 men and 316 women). Single-chamber devices were implanted in 272 (27 atrial and 245 ventricular) and dual chamber in 508 patients. Vascular access was by the subclavian vein in 431 patients and the cephalic vein in 349. Preimplant intravenous antibiotics were administered to 28% and perioperative antibiotics to the remainder; all patients received oral antibiotics after implantation. Of the 780 patients, 41 (5.3%) required an in-hospital stay after implantation because of hematoma formation in 12, pneumothorax in 3, social reasons for 7, observation at the physicians request but no complication for 13, angina in 3, arrhythmia in 1, and warfarin therapy in 2. Immediate complications (<24 hours) occurred in 6 patients an...Continue Reading
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