Resynchronization Pacemaker Research Articles

Spanish pacemaker registry. 20th official report of the Heart Rhythm Association of the Spanish Society of Cardiology (2022)

Introduction and objectivesThis article reports the cardiac pacing activity performed in 2022, including the total number of implants, adherence to remote monitoring, demographic and clinical factors, and the characteristics of the implanted devices. MethodsThe information sources were the CardioDispositivos online platform, the European pacemaker patient identification card, and data provided by the manufacturers. ResultsThe rates of conventional pacemakers and low-energy resynchronizers were 866 and 34 units per million population, respectively. A total of 815 leadless pacemakers were implanted. In all, 16426 procedures performed in 82 hospitals were reported (9407 through CardioDispositivos), representing 40% of the activity. The mean age was 78.6 years, with a predominance of men (60.3%). The most frequent disorder was atrioventricular block, and 14.5% of the patients had atrial fibrillation. There was a predominance of the DDD/R pacing mode (55.6%), and pacing mode was influenced by age, such that more than one-third of patients older than 80 years in sinus rhythm received single-chamber ventricular pacing. The remote monitoring program included 35% of conventional pacemakers and 55% of low-energy resynchronization pacemakers. ConclusionsThe number of conventional pacemakers increased by 5.6%, low-energy resynchronizers by 16%, and leadless pacemakers by 25%. Adherence to remote monitoring was stable. The number of procedures included in CardioDispositivos increased by 11%, although the sample volume decreased. In the coming years, the widespread use of the platform will likely lead to a high-quality registry.

Sudden increase in ventricular pacing in a patient with a cardiac resynchronization pacemaker: What is the explanation?

Sudden increase in ventricular pacing in a patient with a cardiac resynchronization pacemaker: What is the explanation?

Registro español de marcapasos. XX informe oficial de la Asociación del Ritmo Cardiaco de la Sociedad Española de Cardiología (2022)

Introduction and objectivesThis article reports the cardiac pacing activity performed in 2022, including the total number of implants, adherence to remote monitoring, demographic and clinical factors, and the characteristics of the implanted devices. MethodsThe information sources were the CardioDispositivos online platform, the European pacemaker patient identification card, and data provided by the manufacturers. ResultsThe rates of conventional pacemakers and low-energy resynchronizers were 866 and 34 units per million population, respectively. A total of 815 leadless pacemakers were implanted. In all, 16426 procedures performed in 82 hospitals were reported (9407 through CardioDispositivos), representing 40% of the activity. The mean age was 78.6 years, with a predominance of men (60.3%). The most frequent disorder was atrioventricular block, and 14.5% of the patients had atrial fibrillation. There was a predominance of the DDD/R pacing mode (55.6%), and pacing mode was influenced by age, such that more than one-third of patients older than 80 years in sinus rhythm received single-chamber ventricular pacing. The remote monitoring program included 35% of conventional pacemakers and 55% of low-energy resynchronization pacemakers. ConclusionsThe number of conventional pacemakers increased by 5.6%, low-energy resynchronizers by 16%, and leadless pacemakers by 25%. Adherence to remote monitoring was stable. The number of procedures included in CardioDispositivos increased by 11%, although the sample volume decreased. In the coming years, the widespread use of the platform will likely lead to a high-quality registry.

Impact of the Covid19 pandemic on implantable cardiac device implants in Spain. Data from the nationwide Covid 19 RM (remote monitoring) Spain registry

Abstract Funding Acknowledgements Type of funding sources: None. Background The Covid-19 pandemic has meant a very significant reduction in all urgent and non-urgent activity, including the implants of Cardiac Implantable electronic devices (CIEDs) throughout 2020. From the end of 2020 and throughout the year 2021, hospital activity has normalised, but it is uncertain whether the devices that were not implanted within 2020 have been delayed in time or actually lost. Purpose We sought to evaluate the pre and post-pandemic trends in CIEDs implantations from a large nationwide database in order to determine the global effect of the COVID-19 pandemic on CIEDs implants in Spain. Methods The Covid-19 Remote Monitoring Spain Registry (Covid-19 RM-Spain) is a survey supported by the Heart Rhythm Association of the Spanish Society of Cardiology to request the whole national data regarding the number of CIED´s implants and remote monitoring activations from the five main manufacturers classified according to each autonomous community (not by institutions).All data were aggregated and anonymized to analyse the total sample. Appropriate permissions were granted to use the data and a confidentiality agreement was signed in order to avoid any transmission of sensitive information. Results No institution objected to the use of their data, so the total number of devices implanted in Spain were obtained, which were 50258, 52994, 47330 and 54490 in 2018, 2019, 2020 and 2021 respectively. When we try to balance the drop in implants during 2020 and the subsequent increase experienced during 2021 against the average of 2018 and 2019, we have observed that approximately 2600 pacemakers (7%) and about 150 defibrillators (3.1%) have been "lost". With regard to the rest of the devices, adding up the differences between 2020 and 2021 and comparing them with the average for 2018-19, an increase of 419 Cardiac Resynchronization defibrillators (18%), 130 Cardiac Resynchronization Pacemakers (9.4%) and 1189 Implantable Loop recorders ( 26%) have been observed. Conclusion(s) In 2020 there was a large reduction in all CIEDs implants. In the most numerous devices (pacemakers), unlike the rest, the increment has not compensated for the reduction in implants that occurred in 2020 by the end of 2021. The marked increase in the number of cardiac resynchronization implants may suggest that the indication for single or dual-chamber defibrillator implantation may have finally evolved in a significant number of patients into an indication for cardiac resynchronization. Abbreviations: CRT-D: Cardiac resynchronization Therapy -Desfibrillator; CRT-P: Cardiac resynchronization Therapy -pacemaker; ICD: Implantable cardiac defibrillators; ILR: Implantable Loop recorders; LLPM: Leadles Pacemakers; PM: Pacemakers; S-ICD: Subcutaneous Implantable cardiac defibrillator.

Screw-in attempts and success rates in left bundle branch area pacing lead implantation

Abstract Funding Acknowledgements Type of funding sources: None. Background Left bundle branch area pacing (LBBAP) represents a novel cardiac pacing approach that overcomes limitations of conventional right ventricular (septo-) apical pacing. Feasibility and early safety have been shown previously. However, technical limitations (non-dedicated leads, limited availability of suitable implantation sheats) still may preclude successful conduction system pacing (CSP) lead implantation. So-called drilling and entanglement effects can prevent lead implantation at a suitable site and multiple screw-in attempts may be required. However, lead implantation may ultimately still be unsuccessful. Purpose To evaluate the number of total screw-in attempts until abandonment of LBBAP lead implantation during the procedure. Methods We prospectively assessed 170 consecutive LBBAP lead implantation attempts at our center from 09/2021 to 11/2022. All implanters had previous experience with His-bundle pacing lead implantation. Successful conduction system pacing was established according to standard criteria (R-wave peak time in V6, V1-V6-interpeak interval, programmed stimulation or visibility of a left bundle potential) and pacing thresholds <2V/0.5ms. The number of screw-in attempts and decision of LBBAP lead implantation abandonment was at the operator’s discretion. Results Patient baseline characteristics and procedural outcomes are shown in the table (percentages and median values with interquartile range in brackets). Overall CSP lead implantation success rate was 91%. Two patients (1%) experienced complications (one atrial lead dislodgement, one pneumothorax). Median number of screw-in attempts in all interventions was 2 (interquartile range [IQR] 1-4, maximum 12). If implantation was successful, a maximum of four attempts provided already 90% of the overall chance of success (figure). Additional lead implantation attempts rarely provided an additional benefit but prolonged overall implantation duration. Conclusion To balance implantation success rates with procedure duration, the number of screw-in attempts during LBBAP lead implantation may be limited to 4-5 attempts. Bail-out strategies (implantation of a cardiac resynchronization pacemaker or a conventional pacemaker) may be considered if CSP lead implantation is unsuccessful after 4-5 attempts.

Spanish pacemaker registry. 19th official report of the Heart Rhythm Association of the Spanish Society of Cardiology (2021)

Introduction and objectivesThis document includes cardiac pacing activity performed in Spain in 2021: figures for implanted devices, demographic and clinical factors, characteristics of the implanted material, and remote monitoring data. MethodsThe European Pacemaker Patient Card, the CardioDispositivos.es online platform, the centers’ own databases and the data provided by the supplier companies are used as sources of information. Results17.360 procedures were registered from 95 hospitals, which represents 43% of the activity. The implantation rates of conventional and resynchronization pacemakers were 822 and 31 units per million population, respectively. 652 leadless pacemakers were implanted. The mean age of implantation is high (78.8 years), and atrioventricular block is the most frequent electrocardiographic abnormality. Dual-chamber pacing mode predominated, nonetheless single-chamber pacing was performed in 19% of patients in sinus rhythm, mainly in the elderly. 28.5% of implanted conventional pacemakers and 56,2% of low-energy resynchronization pacemakers were included in the remote monitoring program. ConclusionsIn 2021 the number of conventional pacemakers increased by 8.3% and resynchronizers by 18.9%, despite the decrease in low-energy resynchronization, probably attributable to the development of physiological pacing. Leadless pacemakers increased by 25%. The expansion of remote monitoring continued, consolidating as a fundamental follow-up method.

Registro español de marcapasos. XIX informe oficial de la Asociación del Ritmo Cardiaco de la Sociedad Española de Cardiología (2021)

Introduction and objectivesThis document includes cardiac pacing activity performed in Spain in 2021: figures for implanted devices, demographic and clinical factors, characteristics of the implanted material, and remote monitoring data. MethodsThe European Pacemaker Patient Card, the CardioDispositivos.es online platform, the centers’ own databases and the data provided by the supplier companies are used as sources of information. Results17.360 procedures were registered from 95 hospitals, which represents 43% of the activity. The implantation rates of conventional and resynchronization pacemakers were 822 and 31 units per million population, respectively. 652 leadless pacemakers were implanted. The mean age of implantation is high (78.8 years), and atrioventricular block is the most frequent electrocardiographic abnormality. Dual-chamber pacing mode predominated, nonetheless single-chamber pacing was performed in 19% of patients in sinus rhythm, mainly in the elderly. 28.5% of implanted conventional pacemakers and 56,2% of low-energy resynchronization pacemakers were included in the remote monitoring program. ConclusionsIn 2021 the number of conventional pacemakers increased by 8.3% and resynchronizers by 18.9%, despite the decrease in low-energy resynchronization, probably attributable to the development of physiological pacing. Leadless pacemakers increased by 25%. The expansion of remote monitoring continued, consolidating as a fundamental follow-up method.

Estimate and reporting of longevity for cardiac implantable electronic devices: a proposal for standardized criteria

ABSTRACT Background Cardiac implantable electronic devices (CIEDs) are widely used according to consensus guidelines in various patient categories. The longevity of CIED is a major determinant of the frequency with which patients require device replacement. Given the mismatch between the useful life of the devices and patient survival, device replacement is often needed. There is a great variability in the criteria used by manufacturers to determine the longevity of pacemakers (PM), implantable defibrillators (ICDs), and devices for cardiac resynchronization therapy (CRT). Thus, a fair comparison and an effective device evaluation is often difficult. Methods The objective of this paper is to provide standardized criteria based on typical clinical settings for estimating the longevity of single and dual chamber ICDs, cardiac resynchronization defibrillators (CRT-D), single and dual chamber PMs, and cardiac resynchronization PMs (CRT- P) to be used in health technology assessment for an appropriate comparison among different devices. Results The proposed parameters, if applied to the current marketed devices, provide longevity values in the range 5–17.2 years. Conclusion The values of longevity with the non-standardized criteria used by the manufacturers result in higher maximum values respect to the proposed standardized criteria for CRT-D, CRTD-MPP, CRT-P, and Dual-chamber PM.

Spanish Pacemaker Registry. 18th Official Report of the Cardiac Pacing Section of the Spanish Society of Cardiology (2020)

Introduction and objectivesThis report describes the cardiac pacing activity performed in Spain in 2020, including the number and type of implanted devices, demographic and clinical factors, and data on remote monitoring. MethodsInformation consisted of the European Pacemaker Patient Card, data submitted to the cardiodispositivos.es online platform, the databases of participating centers, and supplier-reported data. ResultsA total of 14 662 procedures were registered from 102 hospitals, representing 39.2% of the estimated activity. The implantation rates of conventional and low-energy resynchronization pacemakers were 759 and 31 units per million population, respectively. In all, 520 leadless pacemakers were implanted, 70 with atrioventricular synchrony. The mean age at implantation was high (78.8 years), and the most frequent electrocardiographic change was atrioventricular block. There was a predominance of dual-chamber pacing mode but VVI/R single-chamber pacing was used in 19% of patients in sinus rhythm, depending on age and sex. Remote monitoring capability was present in 18.5% of implanted conventional pacemakers and 45.6% of low-energy resynchronization pacemakers, although registration in this system increased by 53% in 2020. ConclusionsIn 2020, in the context of the SARS-CoV-2 pandemic, the number of implanted conventional pacemakers decreased by 8% and cardiac resynchronization therapy by 4.6%. The number of leadless pacemakers increased by 16.5%. Sequential pacing was predominant, influenced by age and sex. Home monitoring played a fundamental role as a mode of follow-up in this SARS-CoV-2 pandemic year.

Registro Español de Marcapasos. XVIII Informe Oficial de la Sección de Estimulación Cardiaca de la Sociedad Española de Cardiología (2020)

Introduction and objectivesThis report describes the cardiac pacing activity performed in Spain in 2020, including the number and type of implanted devices, demographic and clinical factors, and data on remote monitoring. MethodsInformation consisted of the European Pacemaker Patient Card, data submitted to the cardiodispositivos.es online platform, the databases of participating centers, and supplier-reported data. ResultsA total of 14 662 procedures were registered from 102 hospitals, representing 39.2% of the estimated activity. The implantation rates of conventional and low-energy resynchronization pacemakers were 759 and 31 units per million population, respectively. In all, 520 leadless pacemakers were implanted, 70 with atrioventricular synchrony. The mean age at implantation was high (78.8 years), and the most frequent electrocardiographic change was atrioventricular block. There was a predominance of dual-chamber pacing mode but VVI/R single-chamber pacing was used in 19% of patients in sinus rhythm, depending on age and sex. Remote monitoring capability was present in 18.5% of implanted conventional pacemakers and 45.6% of low-energy resynchronization pacemakers, although registration in this system increased by 53% in 2020. ConclusionsIn 2020, in the context of the SARS-CoV-2 pandemic, the number of implanted conventional pacemakers decreased by 8% and cardiac resynchronization therapy by 4.6%. The number of leadless pacemakers increased by 16.5%. Sequential pacing was predominant, influenced by age and sex. Home monitoring played a fundamental role as a mode of follow-up in this SARS-CoV-2 pandemic year.Full English text available from:www.revespcardiol.org/en

Rationale and design of the HINODE study: Heart failure indication and sudden cardiac death prevention trial Japan.

BackgroundRandomized trials in Western countries have provided evidence that prophylactic implantable cardioverter‐defibrillator (ICD) therapy reduces mortality in heart failure (HF) patients with reduced left ventricular ejection fraction. However, the risk of life‐threatening ventricular arrhythmias in Japanese HF patients sharing similar risk factors is still unknown.MethodsThe Heart Failure Indication and Sudden Cardiac Death Prevention Trial Japan trial (NCT03185832) is a prospective, multicenter registry designed to collect data on ventricular arrhythmia, HF events, and mortality in Japanese HF patients. Japanese patients with HF and 2‐5 predefined risk factors who were indicated for cardiac device implantation based on European Society of Cardiology guidelines were enrolled in four treatment arms: implantable cardioverter‐defibrillator (ICD), cardiac resynchronization therapy defibrillator (CRT‐D), HF pacing (PA; Pacemaker and cardiac resynchronization pacemaker), and nondevice (ND) cohorts and followed for a minimum of 12 months. Since it is anticipated that some baseline patient characteristics and risk factors will differ significantly from those reported in predominantly Western populations, event rates will be compared to a propensity‐matched population from the MADIT RIT trial. Primary endpoints are composite rates of first appropriately treated ventricular arrhythmias (VA) or/and life‐threatening VA symptoms for the ICD and CRT‐D cohorts. For nondevice and PA cohorts, the primary outcome is all‐cause mortality.ConclusionsThe Heart Failure Indication and Sudden Cardiac Death Prevention Trial Japan is a large prospective multicenter registry with defined device treatment cohorts and will provide data for risk stratification for cardiovascular events in Japanese HF patients.

His Bundle Pacing – Stand-alone or adjunctive physiological pacing: a systematic review

His-bundle pacing (HBP) appears to be a viable stand-alone or adjunctive physiological pacing therapy in pacemaker dependent patients. It could also serve as an effective adjunct or alternative pacing therapy for heart failure patients who require cardiac resynchronization therapy or pacemaker upgrade. His-bundle pacing has demonstrated improvement of His-Purkinje conduction, left ventricular electrical / mechanical synchronization, and left ventricular ejection fraction (LVEF) compared with right ventricle pacing. Patients who have high pacing dependence and/or LVEF impairment would benefit most from HBP in terms of heart failure hospitalization and LVEF improvement. Mortality benefit has not been consistently demonstrated in latest meta-analysis. The long-term clinical benefit and safety profile of HBP remains to be explored in future studies. Key words: His bundle pacing, physiologic pacing, upgrade pacing

Spanish Pacemaker Registry. 17th Official Report of the Section on Cardiac Pacing of the Spanish Society of Cardiology (2019)

Introduction and objectivesThis report describes Spanish cardiac pacing activity during 2019: quantities and types of devices and demographic and clinical factors. MethodsThe analysis is based on data obtained from the European Pacemaker Patient Identification Card, data submitted to the online platform cardiodispositivos.es, and supplier-reported data on the total number of implanted pacemakers. ResultsInformation was received on 15 833 procedures from 102 implantation centers, representing 39% of the estimated total activity. The implantation rates of conventional and resynchronization pacemakers were 832 and 32 units per million population, respectively. A total of 431 leadless pacemakers were implanted. Most implantations were performed in elderly patients (mean age, 78.7 years). Most electrodes were bipolar and with active fixation and 34.1% were magnetic resonance imaging-compatible. Atrioventricular block was the most common electrocardiographic abnormality. Dual-chamber sequential pacing predominated; nonetheless, up to 20% of patients in sinus rhythm received a single-chamber ventricular pacemaker, mainly those older than 80 years of age and women. Remote monitoring capability was present in 41% of cardiac resynchronization therapy pacemakers and in 14.8% of conventional pacemakers. ConclusionsConsumption of pacing generators increased by 1.6%, mainly due to a 15.1% increase in cardiac resynchronization therapy pacemakers. Sequential pacing predominates; its use is influenced by age and sex. Remote monitoring increased by 20.6% in cardiac resynchronization therapy pacemakers and continues to be scarce in conventional pacemakers.

Registro Español de Marcapasos. XVII Informe Oficial de la Sección de Estimulación Cardiaca de la Sociedad Española de Cardiología (2019)

Introduction and objectivesThis report describes Spanish cardiac pacing activity during 2019: quantities and types of devices and demographic and clinical factors. MethodsThe analysis is based on data obtained from the European Pacemaker Patient Identification Card, data submitted to the online platform cardiodispositivos.es, and supplier-reported data on the total number of implanted pacemakers. ResultsInformation was received on 15 833 procedures from 102 implantation centers, representing 39% of the estimated total activity. The implantation rates of conventional and resynchronization pacemakers were 832 and 32 units per million population, respectively. A total of 431 leadless pacemakers were implanted. Most implantations were performed in elderly patients (mean age, 78.7 years). Most electrodes were bipolar and with active fixation and 34.1% were magnetic resonance imaging-compatible. Atrioventricular block was the most common electrocardiographic abnormality. Dual-chamber sequential pacing predominated; nonetheless, up to 20% of patients in sinus rhythm received a single-chamber ventricular pacemaker, mainly those older than 80 years of age and women. Remote monitoring capability was present in 41% of cardiac resynchronization therapy pacemakers and in 14.8% of conventional pacemakers. ConclusionsConsumption of pacing generators increased by 1.6%, mainly due to a 15.1% increase in cardiac resynchronization therapy pacemakers. Sequential pacing predominates; its use is influenced by age and sex. Remote monitoring increased by 20.6% in cardiac resynchronization therapy pacemakers and continues to be scarce in conventional pacemakers.

Trends of Acute Kidney Injury Requiring Dialysis Among Hospitalized Patients Undergoing Invasive Electrophysiology Procedures.

Electrophysiology (EP) procedures carry the risk of kidney injury due to contrast/hemodynamic fluctuations. We aim to evaluate the national epidemiology of acute kidney injury requiring dialysis (AKI-D) in patients undergoing EP procedures. Using the National Inpatient Sample, we included 2,747,605 adult hospitalizations undergoing invasive diagnostic EP procedures, ablation and implantable device placement from 2006 to 2014. We examined the temporal trend of AKI-D and outcomes associated with AKI-D. The rate of AKI-D increased significantly in both diagnostic/ablation group (8-21/10,000 hospitalizations from 2006 to 2014, P = 0.02) and implanted device group (19-44/10,000 hospitalizations from 2006 to 2014, P < 0.01), but it was explained by temporal changes in demographics and comorbidities. Cardiac resynchronization therapy and pacemaker placement had higher risk of AKI-D compared to implantable cardioverter-defibrillator placement (23 vs. 31 vs. 14/10,000 hospitalizations in cardiac resynchronization therapy, pacemaker placement, and implantable cardioverter-defibrillator group, respectively). Development of AKI-D was associated with significant increase in in-hospital mortality (adjusted odds ratio, 9.6 in diagnostic/ablation group, P < 0.01; adjusted odds ratio, 5.1 in device implantation group, P < 0.01) and with longer length of stay (22.5 vs. 4.5 days in diagnostic/ablation group, 21.1 vs. 5.7 days in implanted device group) and higher cost (282,775 vs. 94,076 USD in diagnostic/ablation group, 295,660 vs. 102,007 USD in implanted device group). The incidence of AKI-D after EP procedures increased over time but largely explained by the change of demographics and comorbidities. This increasing trend, however, was associated with significant increase in resource utilization and in-hospital mortality in these patients.

Factors influencing the use of leadless or transvenous pacemakers: results of the European Heart Rhythm Association Prospective Survey.

To study the proportion of leadless pacemaker (LL-PM) implants and the factors influencing the choice of LL-PM vs. transvenous pacemaker (TV-PM) across tertiary centres in Europe with routine availability of the LL-PM. A European Heart Rhythm Association (EHRA) prospective snapshot survey using electronically distributed questionnaire sent to participating centres. Participating tertiary cardiac pacing centres prospectively included consecutive patients implanted between November 2018 and January 2019. Questions covered standards of care and policies used for patient management, focusing particularly on the reasons for choosing LL-PM vs. TV-PM. Overall, 21 centres from four countries (France, Netherlands, Spain, and Italy) participated, with eventual data from 798 patients (n = 472, 59% male). With 69 implants, LL-PM represented only 9% of all implants and 36% of the single-chamber pacing group; double-chamber transvenous pacemakers were implanted in 528 patients and biventricular (cardiac resynchronization pacemaker) in 79. The two major reasons reported in favour of LL-PM implantation were an anticipated high risk of infection or low rate of ventricular pacing. Compared to TV-PM, LL-PM patients were more often male (74% vs. 54%, P = 0.009), with greater proportion of valvular heart disease (45% vs. 35%, P = 0.01) and atrial fibrillation (AF; 65% vs. 23%, P < 0.0001), with significantly more comorbidities (≥ one comorbidity, 66% vs. 52%, P = 0.02). This contemporary multicentre European survey shows that LL-PM constitutes a small proportion of all PM implants. Patients implanted with LL-PM were more likely to have AF and a high anticipated risk of infection.

Spanish Pacemaker Registry. 16th Official Report of the Spanish Society of Cardiology Working Group on Cardiac Pacing (2018).

This report describes the result of the analysis of the implanted pacemakers reported to the Spanish Pacemaker Registry in 2018. The analysis is based on the information provided by the European Pacemaker Identification Card and supplier-reported data on the overall number of implanted pacemakers. Information was received from 90 hospitals, with a total of 12 148 cards, representing 31% of the estimated activity. Use of conventional and resynchronization pacemakers was 825 and 77 units per million people, respectively. The mean age of the patients receiving an implant was 78.3 years, and 54% of the devices were implanted in people aged> 80 years. A total of 77.1% were first implants and 21.6% corresponded to generator exchanges. Bicameral sequential pacing was the most frequent pacing mode but was less frequently used in patients aged> 80 years and in women. Single chamber VVI/R pacing was used in 28% of patients with sick sinus syndrome and in 24.7% of those with atrioventricular block, despite being in sinus rhythm. The total consumption of pacemaker generators in Spain increased by 1.2% compared with 2017, mainly due to an 8.7% increase in cardiac resynchronization therapy with pacemaker generators. Selection of pacing mode was directly influenced by age and sex.

Registro Español de Marcapasos. XVI Informe Oficial de la Sección de Estimulación Cardiaca de la Sociedad Española de Cardiología (2018)

Introduction and objectivesThis report describes the result of the analysis of the implanted pacemakers reported to the Spanish Pacemaker Registry in 2018. MethodsThe analysis is based on the information provided by the European Pacemaker Identification Card and supplier-reported data on the overall number of implanted pacemakers. ResultsInformation was received from 90 hospitals, with a total of 12 148 cards, representing 31% of the estimated activity. Use of conventional and resynchronization pacemakers was 825 and 77 units per million people, respectively. The mean age of the patients receiving an implant was 78.3 years, and 54% of the devices were implanted in people aged> 80 years. A total of 77.1% were first implants and 21.6% corresponded to generator exchanges. Bicameral sequential pacing was the most frequent pacing mode but was less frequently used in patients aged> 80 years and in women. Single chamber VVI/R pacing was used in 28% of patients with sick sinus syndrome and in 24.7% of those with atrioventricular block, despite being in sinus rhythm. ConclusionsThe total consumption of pacemaker generators in Spain increased by 1.2% compared with 2017, mainly due to an 8.7% increase in cardiac resynchronization therapy with pacemaker generators. Selection of pacing mode was directly influenced by age and sex.

Spanish Pacemaker Registry. 15th Official Report of the Spanish Society of Cardiology Working Group on Cardiac Pacing (2017)

Introduction and objectivesThis report describes the data reported to the Spanish Pacemaker Registry concerning the activity in cardiac pacing in 2017 in Spain. MethodsThe analysis is based on the data obtained from the European Pacemaker Identification Card and the information reported by supplier companies related to global number of implanted pacemakers. ResultsInformation was received from 106 hospitals, with a total of 12672 cards, representing the 32.1% of the total pacing activity. Conventional pacemaker and resynchronization pacemaker rate was 820 units/million and 26 units/million inhabitants respectively. A total of 333 leadless pacemakers were implanted. The mean age was 77.9 years, predominantly men (58.5%). Most electrodes were bipolar, with active fixation and only 20% had magnetic resonance protection. Atrioventricular block was the most common electrocardiographic disturb. Most patients received bicameral sequential pacing although single chamber VVIR pacing was used in up to 21.8% of patients. Patients older than 80 years benefited less from physiological pacing and resynchronization therapy. ConclusionsTotal use of pacemaker generators remains stable with respect to 2016. Age is the main factor that influences pacing mode selection, which could be improved in around 22% of patients. Leadless pacing continues to rise.

Registro Español de Marcapasos. XV Informe Oficial de la Sección de Estimulación Cardiaca de la Sociedad Española de Cardiología (2017)

Introduction and objectivesThis report describes the data reported to the Spanish Pacemaker Registry concerning the activity in cardiac pacing in 2017 in Spain. MethodsThe analysis is based on the data obtained from the European Pacemaker Identification Card and the information reported by supplier companies related to global number of implanted pacemakers. ResultsInformation was received from 106 hospitals, with a total of 12672 cards, representing the 32.1% of the total pacing activity. Conventional pacemaker and resynchronization pacemaker rate was 820 units/million and 26 units/million inhabitants respectively. A total of 333 leadless pacemakers were implanted. The mean age was 77.9 years, predominantly men (58.5%). Most electrodes were bipolar, with active fixation and only 20% had magnetic resonance protection. Atrioventricular block was the most common electrocardiographic disturb. Most patients received bicameral sequential pacing although single chamber VVIR pacing was used in up to 21.8% of patients. Patients older than 80 years benefited less from physiological pacing and resynchronization therapy. ConclusionsTotal use of pacemaker generators remains stable with respect to 2016. Age is the main factor that influences pacing mode selection, which could be improved in around 22% of patients. Leadless pacing continues to rise.