Pacemaker implantation in small hospitals: complication rates comparable to larger centres

AIMS: Some countries have a demography that makes it necessary to maintain relatively small pacemaker centres. We wanted to assess the quality of pacemaker surgery in two such hospitals. METHODS AND RESULTS: Through patient records we gathered information on ∼535 consecutive primary pacemaker implantations in two small pacemaker centres with 30 and 80 annual operations, respectively. All patients were followed for 3 years. All complications documented in the patient records were registered. Furthermore, we performed a non-systematic literature search comparing our data with reports from major centres published over the last 10 years.We found 72 complications in 64 (12.0%) of the patients, the most common being bleeding, lead failure, and pneumothorax. If minor bleedings without any consequences for the patients are excluded, the number of complications was 46 in 40 patients (7.5%). We had to reoperate on 5.2% of the patients. There was no statistically significant difference in complication rates between the two hospitals. Education candidates generated statistically significant more complications than experienced doctors (13.7 vs. 7.1%, P < 0.05). CONCLUSION: There are no generally accepted norms of complication rates in pacemaker surgery. However, we found no indications that our centres have a rate of complications that is unacceptably high.