DOES EARLY ACTIVATION OF PATIENTS AFTER PACEMAKER IMPLANTATION AFFECT THE RATE OF POST-INTERVENTION COMPLICATIONS?

To study two approaches to the patient activation after primary implantation of single- and dual-chamber pacemakers, 259 patients aged 17 90 years including 80 patients with the early activation and 179 ones with the “standard” activation were examined and treated. The study group did not significantly differ. In the group with the “standard” activation, the patients were requested to stay in bed for 18 20 hours; the patients were strongly recommended to stand up, stay in edgewise position; the patients ate supine, with an elevated head of the bed. The patients with an early activation were allowed to leave the bed 3 hours following the implantation and to eat in the sitting position. The patients of both groups were recommended to restrict hand movements at the side of implantation. No additional devices for shoulder immobilization at the side of implantation were used. X-ray assessment was performed intra-operatively immediately after the pacemaker implantation and one day later. Pacing parameters were assessed one day after implantation and before discharge from hospital.Adverse events related to the pacemaker implantation were observed in 18 patients (6.9%). The electrode dislocation the pacemaker area hematomas were revealed. The early activation did not affect the development of the pacemaker area hematomas (p=0.75). The electrode dislocation was noted in 1.9% of cases. The pacemaker area complications such as a clinically significant hematoma were found in 5% of cases. The incidence of adverse events did not differ in the groups with the early and “standard” activation. No repetitive procedures were required. Thus, no significant difference in the incidence and nature of early post-intervention were revealed; the early activation is deemed to be a safe and well-grounded procedure.

pacemaker implantation, bed regime, electrode dyslocation, hematoma, anticoagulants, disaggregants

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