Demographic and clinical characteristics and factors associated with complications following permanent pacemaker implantation at a cardiac center in Addis Ababa, Ethiopia: a four-year retrospective record review

BACKGROUND: Permanent cardiac pacemaker implantation is an increasingly common, lifesaving intervention for patients with symptomatic bradyarrhythmias, yet data on patient characteristics and outcomes remain limited in Ethiopia. This study aimed to assess the demographic and clinical characteristics of patients and the factors associated with complications following permanent pacemaker implantation at a cardiac center in Ethiopia. METHODS: This retrospective record review was conducted at Gesund Cardiac and Medical Center using a semi-structured data extraction tool to collect data from electronic medical records. A total of 159 patients who underwent pacemaker implantation between July 2018 and June 2022 were included in the study. Data were analyzed using the Statistical Package for the Social Sciences version 26.0. Descriptive statistics were used to summarize patient characteristics, and binary logistic regression was performed to identify factors associated with complications, after checking model fitness and assessing multicollinearity. Adjusted odds ratio with 95% confidence interval was used as an indicator of the strength of association, and statistical significance was set at a P-value < 0.05. RESULTS: The mean (± standard deviation) age of patients was 70 ± 10.9 years, and more than half, 90 (56.6%), were female. Fatigue was the most common presenting symptom (135, 84.9%). Comorbidities were present in 139 (87.4%) of patients, with systemic hypertension being the most common, accounting for 119 (74.8%). Complications occurred in 13 (8.2%) of patients, with hematoma and pocket-site infection being the most common, each observed in three (1.9%) patients. Pneumothorax, deep vein thrombosis and death each occurred in two (1.3%) patients, while lead dislodgement was observed in one (0.6%) patient. Diabetes mellitus (DM) was significantly associated with increased odds of developing complications (adjusted odds ratio: 3.85; 95% confidence interval: 1.11-13.38; P = 0.03). CONCLUSIONS: Permanent pacemaker implantation was performed predominantly in elderly female patients. The overall complication rate was relatively low, and DM was identified as a significant independent factor associated with complications. Close monitoring and tailored management of DM patients are recommended to minimize complication risk, improve procedural outcomes, and inform clinical protocols at cardiac centers in Ethiopia and similar resource-limited settings.