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Complications from cardiac devices range widely from hospital to hospital

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Posted August 1, 2019

We expect quality from our healthcare systems and institutions. We need to be sure that we are getting services of the highest order and we want consistency. However, we are certainly not getting it. Scientists from the University of Adelaide and Flinders University found that cardiac device complications vary widely among hospitals.

Pacemakers are designed to maintain a normal heart rate by delivering short electric impulses. Image credit: Steven Fruitsmaak via Wikimedia (CC BY 3.0)

Complications after having a cardiac device implanted are both scary and painful. They include pain, infections and unimproved cardiovascular condition. Those implants are not necessarily the same. For example, last year nearly 19,000 pacemakers and more than 4000 defibrillators were implanted in Australia alone. Pacemakers se electrical pulses to prompt the heart to beat at a normal rate and are usually implanted in  elderly people who suffer from bradycardia (heart not beating fast enough). Meanwhile defibrillators track the pulse and only deliver electric impulse when abnormalities are observed.

Cardiovascular implantable electronic devices (CIED) are very important and for some people they are life-saving. This new study included 81,304 patients who received a new CIED with 65,711 permanent pacemakers and 15,593 implantable cardioverter-defibrillators. Both of these devices are rather costly and for some people they are not a matter of choice. Of course, depending on a country, the healthcare system may cover the cost of the device and insertion, but people still should demand quality. However, complications are common.

Scientists found that 8.2 % of CIED insertions deliver complication within 90 days of the operation. This number reflects the reality of the procedure – it is a major surgical intervention and complications are likely. However, what scientists found was giant differences between hospitals in terms of frequencies of complications. In some cases statistics differed 2-3 times. 

Associate Professor Anand Ganesan, a study co-investigator, said: “What this study really shows is that we should be routinely reporting hospital complication rates to make these fully visible to clinicians, hospitals and the community at large. We should also invest in strategies proven to reduce these, such as optimising procedural technique, adopting better infection control measures, and managing blood thinning drugs peri-procedure”.

CIED procedures are going to be more and more important in the future as population is ageing. It is very important to ensure the highest degree of quality. Hopefully, statistics of each hospital will help them improve.

 

Source: University of Adelaide

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