Introduction: : In existing guidelines ACC/AHA/HRS and ECS there are no clear instructions about periods of patient physical activation after pacemaker implantation procedures.
Methods: To assess the amount and structure of early postprocedural complications after primary pacemaker implantations in association with time of patient physical activation. Materials and methods: 259 patients after primary pacemaker implantations were included in our study with randomization 1:2. In the first group (80 patients) confinement to bed was discontinued 3 hours after the procedure while in the second group (179 patients) – 15-20 hours after the procedure. We assessed complications associated with lead displacement, pocket hematoma and others (embolism, pneumonia, stroke, etc.). During implantation procedures we used only leads with active fixation. Mean period of patient observation was 5 days.
Results: The second group included more patients with dual chamber pacemakers (p=0,02), the duration of procedures was longer (p=0,0006), aspirin and warfarin administration was more common (p<0,0001 and p=0,03 respectively). Lead displacement was diagnosed in 5 patients, differences between groups were insignificant (p=0,62). Pocket hematoma occurred in 13 patients and the differences were also insignificant (p=0,97). We did not observe other complications in our patients. Pocket hematomas usually occurred to 4th day after the procedure. Aspirin administration seems to be an independent predictor of this complication (p=0,02).
Conclusions: Early physical activation of patients after primary pacemaker implantations does not affect the rate of such complications as lead displacement or pocket hematoma formation. Administration of aspirin increases the risk of hematoma. Considering the time of hematoma occurrence it is suitable to check the pocket during first 4 days after implantation.