Patients with cardiac bradyarrhythmias and pacemaker reuse
Keywords:
artificial cardiac pacing, atrioventricular block, pacemaker artificialAbstract
Introduction: Pacing is an effective treatment method for patients with cardiac bradyarrhythmias. Reusing pacemakers represents a viable alternative to overcome the high costs of these devices.
Objective: To characterize patients with cardiac bradyarrhythmias and the reuse of pacemaker generators as a definitive treatment alternative.
Methods: Prospective series of 58 patients with bradyarrhythmias. Demographic, clinical, electrocardiographic, and pacemaker implantation-related variables were evaluated. SPSS statistical software was used to calculate absolute numbers and percentages for qualitative variables, and the mean and standard deviation for quantitative variables. Qualitative variables were compared using the chi-square test and Fisher's test, with a p < 0.05 statistical significance level.
Results: Women predominated (62.1%) with an average age of 77.9 ± 9.9years. Complete atrioventricular block (43.1%) and syncope (63.8%) were predominant, with no difference according to sex (p = 0.08; p = 0.41), respectively. Pacemakers were implanted in 82.7% of cases, mostly recovered (79.2%) with VVI modality (64.6%). Complications occurred in 17.2%. Death (8.6%) and pneumothorax (3.4%) were the most prevalent, with no difference according to sex (p = 0.92; p = 0.72), respectively, and not directly related to the implants.
Conclusions: Syncope and complete atrioventricular block are the predominant reasons for admission in patients with cardiac bradyarrhythmias. The reuse of pacemakers allows the implantation rate to be maintained with a low rate of immediate complications.
Downloads
References
1. Lippi G, Sanchis-Gomar F, Cervellin G. Global epidemiology of atrial fibrillation: An increasing epidemic and public health challenge. International Journal of Stroke. 2020;16(2):217-21. DOI:10.1177/1747493019897870
2. Chugh S, Havmoeller R, Narayanan K, Singh D, Rienstra M, Benjamin E, et al. Worldwide epidemiology of atrial fibrillation: a Global Burden of Disease 2010 Study [Internet]. Circulation. 2014;129(8):837-47. DOI: 10.1161/CIRCULATIONAHA.113.005119
3. Hafeez Y, Grossman S. Sinus Bradycardia (nursing) [Internet]. Treasure Island: Stat Pearls; 2023. [acceso: 10/10/2024]. Disponible en: https://europepmc.org/article/NBK/nbk568806
4. Sidhu S, Marine JE. Evaluating and managing bradycardia [Internet]. Trends Cardiovasc Med. 2020; 30(5):265-72. DOI: 10.1016/j.tcm.2019.07.001
5. Montenegro L, Vignoli G, Rodríguez I. Bradiarritmias: Do diagnóstico ao tratamento [Internet]. Med Ciên e Arte, Rio de Janeiro. 2022 [acceso: 10/10/2024];1 (3):36-48. Disponible en: https://medicinacienciaearte.emnuvens.com.br/revista/article/view/30
6. Rodríguez J, Coma S. Historia de la estimulación cardiaca eléctrica. Parte I [Internet]. Cuadernos técnicos de estimulación cardiaca. 2005[acceso: 10/10/2024];(11):1-16. Disponible en: https://secardiologia.es/images/stories/secciones/estimulacion/cuadernos-estimulacion/1105/historia-de-la-estimulacion-cardiaca-i.pdf
7. González R, Pérez J. Reutilización de marcapasos en Cuba: una solución ante la escasez [Internet]. Rev Cub Cardiol. 2020 [acceso: 10/10/2024]; 36(2): 45-50. Disponible en: https://revcalixto.sld.cu/index.php/ahcg/article/download/e1110/904?inline=1
8. Quiñones I, Leal E, Machín L, Ocaña L, Rodríguez M, Tran Y. Reuso de marcapasos permanentes como estrategia emergente [Internet]. Arch Hosp Univer Calixto García. 2023 [acceso: 20/12/2024]; 11(2): e1110. Disponible en: https://revcalixto.sld.cu/index.php/ahcg/article/view/e1110
9. Casado R, Porta A, Salvador O, Sánchez C, Bayona S, Veja A, et al. Bradiarritmias y bloqueos cardíacos [Internet]. Medicina. 2021 [acceso: 10/10/2024]; 13(44):2577–90. Disponible en: https://www.sciencedirect.com/science/article/pii/S0304541221002778
10. Concha M, Osorio K, Riquelme V, Kappes M, Leyton W, Eichele D. Caracterización de marcapasos implantados en un hospital de alta complejidad, 2018-2023 [Internet]. Rev Fed Arg Cardiol. 2025 [acceso: 10/10/2024]; 54(1):45-9. Disponible en: https://revistafac.org.ar/ojs/index.php/revistafac/article/view/620
11. Sánchez S, Echazabal M, Navarro AL, Sánchez E. Caracterización de los pacientes con bradiarritmias atendidos en el servicio de Cardiología de Cienfuegos (2018-2019) [Internet]. Medisur. 2020 [acceso: 10/10/2024]; 18(6):1110-21. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1727897X2020000601110&lng=es
12. Jiménez M. García J, Martínez Ferrer J. Registro español de marcapasos. XIX informe oficial de la Asociación del Ritmo Cardiaco de la Sociedad Española de Cardiología (2021) [Internet]. Rev Esp Cardiol. 2021 [acceso: 10/10/2024];75(11):949–59. Disponible en: www.revespcardiol.org/es-registro-espanol-marcapasos-xix-informe-articulo-S0300893222003347
13. Minsap. Anuario Estadístico de Cuba Edición 2024 [Internet]. La Habana; Minsap, Dirección Nacional de Registros Médicos y Estadísticas de Salud; 2024. [acceso: 02/08/2025]. Disponible en: https://files.sld.cu/dne/files/2024/09/Anuario-Estad%c3%adstico-de-Salud-2023-EDICION-2024.pdf
14. Teixeira R, Alves A, Baggio JM, De Oliveira JC, Medeiros P, Pereira B, et al. Diretriz Brasileira de Dispositivos Cardíacos Eletrônicos Implantáveis –2023 [Internet]. Arq Bras Cardiol. 2023 [acceso: 12/10/2024]; 1(120):e20220892. Disponible en: https://abccardiol.org/article/diretriz-brasileira-de-dispositivos-cardiacos-eletronicos-implantaveis-2023/
15. Jurubeba AKX, Khanjar AS, Fraga AS, Dragalzew DC, Grion JM, Ribeiro JPV, Melo NM, et al. Os benefícios tecnológicos e o potencial risco de complicações no pós-operatório do implante de marcapasso [Internet]. Epitaya E-Books; 2024. DOI: https://doi.org/10.47879/ed.ep.2024264p121
16. Organización Panamericana de la Salud. Iniciativa HEARTS en las Américas 2023 [Internet]. [acceso: 12/10/2024]. Disponible en: https://www.paho.org/es/hearts-americas
17. Roth G, Mensah G, Johnson C. Global Burden of Cardiovascular Disease and risk factors, 1990-2019 [Internet]. J Am Coll Cardiol. 2020 [acceso: 12/10/2024]; 76(25): 2982-3021. Disponible en: https://pubmed.ncbi.nlm.nih.gov/33309175/
18. Emin M, Erden O, Nurdan N. How should we approach syncope in the emergency department? Current perspectives [Internet]. Open Access Emerg Med. 2022 [acceso: 12/10/2024]; 14:299-309. Disponible en: https://www.ncbi,nlm.nih.gov/pmc/articles/PMC9249662/
19. Cadavid V, Ibata D, Franco P, Valderrama Z. Complicaciones asociadas al implante de dispositivos cardiacos electrónicos [Internet]. Rev Colomb Cardiol. 2020 [acceso: 12/10/2024]; 27(5): 420-7. DOI: https://doi.org/10.1016/rccar.2019.02.005
20. Jiménez J, Oterino A, Galbán A, Hernández J, Morínigo J, García M, et al Resultados de un servicio ininterrumpido de implante urgente de marcapasos permanente [Internet]. Rev Esp de Cardiol. 2024 [acceso: 12/10/2024]; 77(11): 899-909. Disponible en: https://produccioncientifica.usal.es/documentos/6665f2c7be265147d9b63564
21. Glikson M, Cosedis J, Brix M, Michowitz Y, Auricchio A, Moshe I, et al. Guía ESC 2021 sobre estimulación cardiaca y terapia de resincronización cardiaca [Internet]. Cardiología. 2022; 75: 370-410. DOI: https://doi.org/10.1016/j.recesp.2021.11.001
22. Cartón A, Gambra I. Alteraciones del ritmo cardiaco [Internet]. Adolescere. 2024 [acceso: 12/10/2024]; XII (3): 30-44. Disponible en: https://www.adolescere.es/revista/pdf/volumen-XII-n3-2024/2024-n3-30-44-Tema-de-revision-Alteraciones-del-ritmo-cardiaco-AJ.Carton.pdf
23. Defaye P, Biffi M, El-Chami M, Bóveda S, Glikson M, Piccini J, et al. Cardiac pacing and lead devices management: 25 years of research at EP Europace journal [Internet]. Europace. 2023; 25: 1-16. DOI: 10.1093/europace/euad202
24. Ochagavía A, Baigorri F. Selección del modo de estimulación del marcapasos [Internet]. Med. Intensiva. 2006 [acceso: 12/10/2024]; 30(5): 218-22. Disponible en: https://scielo.iscii.es/scielo.php?script=sci_arttextpid=so210-56912006000500005lng=es
25. Bartholomew P, James K, Williams L. Ethical considerations in pacemaker reuse: A Caribbean perspective [Internet]. West Indian Med J. 2022 [acceso: 20/12/2024]; 71(1): 45-50. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S2352552522000664
26. Lorenzo I, Gaztañaga L, Marichalar X, Martinez R, Arraña L. Patient’s opinions on cardiac implantable electronic devices reuse in Bolivia [Internet]. J Interv card Electrophysiol. 2023 [acceso: 20/12/2024]; 6(23): 1527-47. Disponible en: https://link.spring.com/article/10.1007/s10840-022-011375-x
27. Medicines and health care products regulatory agency. Single-use medical devices: implications and consequences of reuse; medicines and health care products Regulatory Agency. MHRA; 2021. [acceso: 20/12/2024]; disponible en: https://assets.publishing.service.gov.uk/media/60117a378fa8f565559191cd/Single_use_medical_devices.pdf
28. Kelaher M, Semsariam C, Puranik R. Reuse of explanted permanent pacemakers: A systematic review and meta-analysis [Internet]. Heart Rhythm. 2022 [acceso: 20/12/2024]; 19(5):1-100. Disponible en: https://pubmed.ncbi.nlm.nih.gov/33969787
29. Centro de Control Estatal de Medicamentos y Dispositivos Médicos. Normativas para equipos médicos reusados. La Habana: CECMED; 2020. [acceso: 20/12/2024]. Disponible en: https://www.cecmed.cu/reglamentacion/aprobada
30. Khairy T, Lupien M, Nava S, Valdez F, Solares F, Linarez N, et al. Infections Associated with Resterilized Pacemakers and Defibrillators [Internet]. N Engl J Med. 2020 [acceso: 20/12/2024]; 382(19):1823-31. Disponible en: https://pubmed.ncbi.nlm.nih.gov/32374963/
31. Antunes M, Bunda JR, Baião D, Magalhães E, Martins t, Bornelli L, et al Caracterização clínico-epidemiológica dos pacientes submetidos a implantação de dispositivos eletrônicos cardíacos em um hospital terciário privado angolano [Internet]. Braz J C Report. 2021; 1(3):142-51. DOI: 10.52600/2763-583X.bjcr.2021.1.3.142-151
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Roger Ravelo Dopico, Rosmery de la Caridad González Lazo, Leonardo Feliciano Fonseca Bring, José Carlos Carmona Barrera, Liz Odelmis Cruz Rodriguez, Yoanis Cardenas Fernández
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Authors who have publications with this Journal accept the following terms:
- The authors will retain their copyright and guarantee the Journal the right of first publication of their work, which will simultaneously be subject to the Creative Commons Attribution License. The content presented here can be shared, copied and redistributed in any medium or format; Can be adapted, remixed, transformed or created from the material, using the following terms: Attribution (giving appropriate credit to the work, providing a link to the license, and indicating if changes have been made); non-commercial (you cannot use the material for commercial purposes) and share-alike (if you remix, transform or create new material from this work, you can distribute your contribution as long as you use the same license as the original work).
- The authors may adopt other non-exclusive license agreements for the distribution of the published version of the work (for example: depositing it in an institutional electronic archive or publishing it in a monographic volume) as long as the initial publication in this Journal is indicated.
- Authors are allowed and recommended to disseminate their work through the Internet (e.g., in institutional electronic archives or on their website) before and during the submission process, which can produce interesting exchanges and increase citations. of the published work.
