IS A ROUTINE POST PACE MAKER IMPLANTATION CHEST X RAY MANDATORY? DATA FROM A TERTIARY CARE HOSPITAL IN A DEVELOPING COUNTRY
Objective: To determine the yield of routine chest X-Ray for ruling out majorcomplications after implantation of permanent pacemaker.
Methodology: We conducted an observational cross sectional study of patientsundergoing permanent pacemaker insertion at The Aga Khan University HospitalKarachi, from October 2009 till December 2012 with average age of 70.1 and68.8 years respectively. Population was divided into two groups including dualchamber pacemaker and single chamber pacemaker.
Results: This study included 317 patients who undergone permanent pacemaker. Pneumothorax and lead displacement occurred in 0.63% and 1.57%,respectively. The pneumothoraxes were large and clinically significant and pickedup clinically, which could have been predicted using the lung/chest pathology inthe pre implant CXR. The lead displacements were picked by symptoms andpacemaker interrogation.
Conclusion: We have shown that in a tertiary care center and in the hands ofexperienced operators, with a good pre-implant and post implant examinationand a routine device interrogation, the routine CXR can be skipped afterimplantation of permanent pacemaker.
Key Words: Chest X Ray, Permanent Pacemaker, Complications, Pneumothorax,Lead Displacement