Arrhythmias & electrophysiologyCohort study
Permanent pacemaker implantation after cardiac surgery and long-term outcome
- nationwide registry-based study
- Cox proportional hazards models
Authors' conclusion
Permanent pacemaker implantation after cardiac surgery was associated with a higher risk of all-cause mortality and heart failure hospitalisation. These findings were consistent across cardiac surgical subtypes and underscore the need for careful long-term surveillance for these patients.
Study context
- Population
- Adult patients in Sweden without previous CIED who had cardiac surgery between 2006 and 2020mean age 67.8 years, 25% female
- Participants
- 76,223 patients
- Exposure
- association between permanent pacemaker or implantable cardioverter defibrillator (ICD) implantation and the risk of all-cause mortality, cardiovascular mortality and heart failure hospitalisation
- Permanent pacemakern = 2,150
- ICDn = 348
Main finding
All-cause mortality · mean follow-up of 6.8 years (SD 10.7)
Adjusted hazard ratio
1.09
95% CI 1.01–1.19
Permanent pacemaker
aHR 1.09 (95% CI 1.01–1.19)
As reported in the abstract
Observational data: associations, not effects.
Further findings
Heart failure hospitalisation · mean follow-up of 6.8 years (SD 10.7)
| Comparison | aHR (95% CI) | |
|---|---|---|
| Permanent pacemaker · higher risk with pacemaker implantation | 1.36 (1.22–1.52) | |
| 0.512Adjusted hazard ratio (log scale) |
Cardiovascular mortality (pacemaker)
- Cardiovascular mortality showed a similar but statistically non-significant trend
ICD implantation outcomes
- ICD implantation was not associated with all-cause mortality but was associated with increased risks of heart failure hospitalisation and cardiovascular mortality
Subgroup analyses
- Subgroup analyses did not show any significant interactions between comorbid conditions and outcomes
Original publication
Permanent pacemaker implantation after cardiac surgery and long-term outcome. Heart. Published 21 September 2026. doi:10.1136/heartjnl-2026-328361
Summarised from the published abstract; every number is checked against it