Implantation of 500 consecutive cardiac pacemakers in the electrophysiology laboratory

Objective - The purpose of this study was to examine the practice of cardia c bradycardia pacing in an electrophysiology laboratory and to evaluate the safety and efficacy of pacemaker implantation by cardiologists in this set ting. Methods and results - We evaluated a consecutive series of the first 500 pe rmanent pacemakers (mean age of patients: 74 +/- 14 years) implanted entire ly in the electrophysiology laboratory at our institution. All procedures w ere performed by two cardiologists. Three-hundred and four patients (60.8%) received a dual-chamber device. After 3 months of follow-up, procedure-rel ated com plications occurred in 19 patients (3.8%). The most frequent compl ication was lead dislodgement (1.4%). There were 2 postoperative infections (0.4%). The mean time to hospital discharge after the implant was 2.9 +/- 1.6 days. Conclusions - These results show that permanent pacemaker implantation may be successfully carried out by cardiologists in the electrophysiology labor atory with a low complication rate. Atrial lead dislodgement seems to be th e most frequent complication in centres with a high proportion of dual-cham ber pacemaker implantations.