Assessment of Trend, Indication, Complications, and Outcomes of Pacemaker Implantation in Adult Patients at Tertiary Hospital of Ethiopia: Retrospective Follow Up Study

Figures & data

Table 1 Shows the Sociodemographic and Clinical Characteristics of Patients Who Underwent Pacemaker Implantation in Tikur Anbessa Hospital from 2017 to 2022

Sociodemographic Characteristics	Frequency	Percentage
Age of the patient
23–70 years	93	78.8
71–90 years	25	21.2
Sex
Male	60	50.8
Female	58	49.2
Residence
Addis Ababa	66	56
Out of Addis Ababa	52	44
Clinical characteristics
Symptoms before pacemaker implantation
Syncope and dyspnoea on mild exertion	26	22
Presyncope, syncope, and dyspnoea on mild exertion	29	24.6
Syncope, light-headedness, and dyspnoea on mild exertion	63	53.4
Comorbidities
Hypertension	64	54.2
Hypertension and diabetes mellitus	14	11.9
Others (diabetes mellitus, HIV, thyrotoxicosis, COPD, CVA)	7	5.9
Structural heart diseases (chronic rheumatic heart disease, ischemic heart disease)	11	9.3
None	22	18.6
History of heart failure
Yes	18	15.3
No	100	84.7
Echocardiographic finding
LVH	34	27.1
Pulmonary hypertension	17	14.4
Degenerative heart diseases	21	17.8
Others ((HCM, ischemic heart diseases, rheumatic heart diseases, prosthetic valve, Epstein anomaly of tricuspid valve)	14	11.9
Normal	34	28.8
Anticoagulants
Warfarin or rivaroxaban	8	6.8
No anticoagulants	110	93.2
Other medications
Aspirin	8	6.8
Aspirin, amlodipine and enalapril	27	22.9
Amlodipine	21	17.8
Enalapril	15	12.7
Diuretics (furosemide and hydrochlorothiazide)	8	6.8
Others (insulin, oral hypoglycaemic agents, beta-blockers, propylthiouracil)	13	11
No medications	26	22
Indications for pacemaker implantation
Symptomatic 3rd-degree AV block	93	78.8
Atrial fibrillation with fixed block	8	6.8
Initially for 3^rd degree block later for generator depletion	7	5.9
2:1 2nd-degree AV block and sinus node dysfunction	10	8.5
Implanted by
Local team	64	54.2
During the campaign/mission	54	45.8
Implantation procedure
1^st time	107	90.7
For generator change	7	5.9
Lead removal and reimplantation	4	3.4
Generator type
Medtronic	73	61.9
St Jude	45	38.1
Mode of pacemaker
Single chamber (VVIR)	24	20.3
Double chamber (DDIR, DDDR)	94	79.7
Adherence
Adherent	54	45.8
Not adherent	64	54.2
Complications
At least one complication	18	15.3
No complication	100	84.7

Figure 1 Number and type of complications of patients who underwent pacemaker implantation in Tikur Anbessa Hospital from 2017 to 2022.

Table 2 Shows Factors Associated with Complication of Patients Who Underwent Pacemaker Implantation in Tikur Anbessa Hospital from 2017 to 2022

Sociodemographic Characteristics	No Complication N (%)	At Least One Complication N (%)	P value
Age of the patient at procedure			0.02
<=70 years	83(83)	10(55.6)
>70 years	17(17)	8(44.4)
Sex			0.04
Male	55(55)	5(27.8)
Female	45(45)	13(72.2)
Residence			0.61
Addis Ababa	57(57)	9(55.6)
Out of Addis Ababa	43(43)	9(44.4)
Clinical characteristics
Symptoms			0.12
Syncope and dyspnoea on mild exertion	23(23)	3(16.7)
Presyncope, syncope, and dyspnoea on mild exertion	21(21)	8(44.4)
Light-headedness, syncope, and dyspnoea	56(56)	7(38.9)
Comorbidities			0.32
Hypertension	56(56)	8(44.4)
Hypertension and diabetes mellitus	10(10)	4(22.2)
Others (diabetes mellitus, HIV, thyrotoxicosis, COPD, CVA)	6(6)	1(5.6)
Structural heart diseases (chronic rheumatic heart disease, ischemic heart disease)	8(8)	3(16.7)
None	20(20)	2(11.1)
History of heart failure			0.47
Yes	14(14)	4(22.2)
No	86(86)	14(77.8)
Echocardiographic finding			0.95
LVH	27(27)	5(27.8)
Pulmonary hypertension	15(15)	2(11.1)
Degenerative heart diseases	17(14.4%)	4(3.4%)
Others ((HCM, ischemic heart diseases, rheumatic heart diseases, prosthetic valve, Epstein anomaly of tricuspid valve)	13(13)	1(5.6)
Normal	28(28)	6(33.3)
Anticoagulants			0.61
Warfarin or rivaroxaban	8(8)	0(0)
No anticoagulants	92(92)	18(100)
Other medications			0.16
Aspirin	7(7)	1(5.6)
Aspirin, amlodipine and enalapril	22(22)	5(27.8)
Amlodipine	20(20)	1(5.6)
Enalapril	13(13)	2(11.1)
Diuretics (furosemide and hydrochlorothiazide)	6(6)	2(11.1)
Others (insulin, oral hypoglycaemic agents, beta-blockers, propylthiouracil)	8(8)	5(27.8)
No medications	24(24)	2(11.1)
Indications for pacemaker implantation			0.21
Symptomatic 3rd-degree AV block	81(81)	12(66.7)
Atrial fibrillation with fixed block	7(7)	1(5.6)
Initially for 3^rd degree block later for generator depletion	5(5)	2(11.1)
2:1 2nd-degree AV block and sinus node dysfunction	7(7)	3(16.7)
Implanting team			0.01
Local team	49(49)	15(83.3)
During the campaign/mission	51(51)	3(16.7)
Implantation procedure			0.26
1^st time	92(92)	15(83.3)
For generator change	5(5)	2(11.1)
Lead removal and reimplantation	3(3)	1(5.6)
Generator type			0.2
Medtronic	59(59)	14(77.8)
Sent Jude	41(41)	4(22.2)
Mode of pacemaker			1
Single chamber (VVIR)	21(21)	3(16.7)
Double chamber (DDIR, DDDR)	79(79)	15(83.3)
Adherence			0.04
Adherent	50(50)	4(22.2)
Not adherent	50(50)	14(78.8)