Spanish pacemaker registry. 20th official report of the Heart Rhythm Association of the Spanish Society of Cardiology (2022).

INTRODUCTION AND OBJECTIVES: This article reports the cardiac pacing activity performed in 2022, including the total number of implants, adherence to remote monitoring, demographic and clinical factors, and the characteristics of the implanted devices. METHODS: The information sources were the CardioDispositivos online platform, the European pacemaker patient identification card, and data provided by the manufacturers. RESULTS: The rates of conventional pacemakers and low-energy resynchronizers were 866 and 34 units per million population, respectively. A total of 815 leadless pacemakers were implanted. In all, 16426 procedures performed in 82 hospitals were reported (9407 through CardioDispositivos), representing 40% of the activity. The mean age was 78.6 years, with a predominance of men (60.3%). The most frequent disorder was atrioventricular block, and 14.5% of the patients had atrial fibrillation. There was a predominance of the DDD/R pacing mode (55.6%), and pacing mode was influenced by age, such that more than one-third of patients older than 80 years in sinus rhythm received single-chamber ventricular pacing. The remote monitoring program included 35% of conventional pacemakers and 55% of low-energy resynchronization pacemakers. CONCLUSIONS: The number of conventional pacemakers increased by 5.6%, low-energy resynchronizers by 16%, and leadless pacemakers by 25%. Adherence to remote monitoring was stable. The number of procedures included in CardioDispositivos increased by 11%, although the sample volume decreased. In the coming years, the widespread use of the platform will likely lead to a high-quality registry.

Spanish pacemaker registry. 19th official report of the Heart Rhythm Association of the Spanish Society of Cardiology (2021).

INTRODUCTION AND OBJECTIVES: This document includes cardiac pacing activity performed in Spain in 2021: figures for implanted devices, demographic and clinical factors, characteristics of the implanted material, and remote monitoring data. METHODS: The European Pacemaker Patient Card, the CardioDispositivos.es online platform, the centers' own databases and the data provided by the supplier companies are used as sources of information. RESULTS: 17.360 procedures were registered from 95 hospitals, which represents 43% of the activity. The implantation rates of conventional and resynchronization pacemakers were 822 and 31 units per million population, respectively. 652 leadless pacemakers were implanted. The mean age of implantation is high (78.8 years), and atrioventricular block is the most frequent electrocardiographic abnormality. Dual-chamber pacing mode predominated, nonetheless single-chamber pacing was performed in 19% of patients in sinus rhythm, mainly in the elderly. 28.5% of implanted conventional pacemakers and 56,2% of low-energy resynchronization pacemakers were included in the remote monitoring program. CONCLUSIONS: In 2021 the number of conventional pacemakers increased by 8.3% and resynchronizers by 18.9%, despite the decrease in low-energy resynchronization, probably attributable to the development of physiological pacing. Leadless pacemakers increased by 25%. The expansion of remote monitoring continued, consolidating as a fundamental follow-up method.

Spanish Pacemaker Registry. 18th Official Report of the Cardiac Pacing Section of the Spanish Society of Cardiology (2020).

INTRODUCTION AND OBJECTIVES: This report describes the cardiac pacing activity performed in Spain in 2020, including the number and type of implanted devices, demographic and clinical factors, and data on remote monitoring. METHODS: Information consisted of the European Pacemaker Patient Card, data submitted to the cardiodispositivos.es online platform, the databases of participating centers, and supplier-reported data. RESULTS: A total of 14 662 procedures were registered from 102 hospitals, representing 39.2% of the estimated activity. The implantation rates of conventional and low-energy resynchronization pacemakers were 759 and 31 units per million population, respectively. In all, 520 leadless pacemakers were implanted, 70 with atrioventricular synchrony. The mean age at implantation was high (78.8 years), and the most frequent electrocardiographic change was atrioventricular block. There was a predominance of dual-chamber pacing mode but VVI/R single-chamber pacing was used in 19% of patients in sinus rhythm, depending on age and sex. Remote monitoring capability was present in 18.5% of implanted conventional pacemakers and 45.6% of low-energy resynchronization pacemakers, although registration in this system increased by 53% in 2020. CONCLUSIONS: In 2020, in the context of the SARS-CoV-2 pandemic, the number of implanted conventional pacemakers decreased by 8% and cardiac resynchronization therapy by 4.6%. The number of leadless pacemakers increased by 16.5%. Sequential pacing was predominant, influenced by age and sex. Home monitoring played a fundamental role as a mode of follow-up in this SARS-CoV-2 pandemic year.

Spanish Pacemaker Registry. 17th Official Report of the Section on Cardiac Pacing of the Spanish Society of Cardiology (2019).

INTRODUCTION AND OBJECTIVES: This report describes Spanish cardiac pacing activity during 2019: quantities and types of devices and demographic and clinical factors. METHODS: The analysis is based on data obtained from the European Pacemaker Patient Identification Card, data submitted to the online platform cardiodispositivos.es, and supplier-reported data on the total number of implanted pacemakers. RESULTS: Information was received on 15 833 procedures from 102 implantation centers, representing 39% of the estimated total activity. The implantation rates of conventional and resynchronization pacemakers were 832 and 32 units per million population, respectively. A total of 431 leadless pacemakers were implanted. Most implantations were performed in elderly patients (mean age, 78.7 years). Most electrodes were bipolar and with active fixation and 34.1% were magnetic resonance imaging-compatible. Atrioventricular block was the most common electrocardiographic abnormality. Dual-chamber sequential pacing predominated; nonetheless, up to 20% of patients in sinus rhythm received a single-chamber ventricular pacemaker, mainly those older than 80 years of age and women. Remote monitoring capability was present in 41% of cardiac resynchronization therapy pacemakers and in 14.8% of conventional pacemakers. CONCLUSIONS: Consumption of pacing generators increased by 1.6%, mainly due to a 15.1% increase in cardiac resynchronization therapy pacemakers. Sequential pacing predominates; its use is influenced by age and sex. Remote monitoring increased by 20.6% in cardiac resynchronization therapy pacemakers and continues to be scarce in conventional pacemakers.

Spanish Pacemaker Registry. 16th Official Report of the Spanish Society of Cardiology Working Group on Cardiac Pacing (2018).

INTRODUCTION AND OBJECTIVES: This report describes the result of the analysis of the implanted pacemakers reported to the Spanish Pacemaker Registry in 2018. METHODS: The analysis is based on the information provided by the European Pacemaker Identification Card and supplier-reported data on the overall number of implanted pacemakers. RESULTS: Information was received from 90 hospitals, with a total of 12 148 cards, representing 31% of the estimated activity. Use of conventional and resynchronization pacemakers was 825 and 77 units per million people, respectively. The mean age of the patients receiving an implant was 78.3 years, and 54% of the devices were implanted in people aged> 80 years. A total of 77.1% were first implants and 21.6% corresponded to generator exchanges. Bicameral sequential pacing was the most frequent pacing mode but was less frequently used in patients aged> 80 years and in women. Single chamber VVI/R pacing was used in 28% of patients with sick sinus syndrome and in 24.7% of those with atrioventricular block, despite being in sinus rhythm. CONCLUSIONS: The total consumption of pacemaker generators in Spain increased by 1.2% compared with 2017, mainly due to an 8.7% increase in cardiac resynchronization therapy with pacemaker generators. Selection of pacing mode was directly influenced by age and sex.

Spanish Pacemaker Registry. 15th Official Report of the Spanish Society of Cardiology Working Group on Cardiac Pacing (2017).

INTRODUCTION AND OBJECTIVES: This report describes the data reported to the Spanish Pacemaker Registry concerning the activity in cardiac pacing in 2017 in Spain. METHODS: The analysis is based on the data obtained from the European Pacemaker Identification Card and the information reported by supplier companies related to global number of implanted pacemakers. RESULTS: Information was received from 106 hospitals, with a total of 12672 cards, representing the 32.1% of the total pacing activity. Conventional pacemaker and resynchronization pacemaker rate was 820 units/million and 26 units/million inhabitants respectively. A total of 333 leadless pacemakers were implanted. The mean age was 77.9 years, predominantly men (58.5%). Most electrodes were bipolar, with active fixation and only 20% had magnetic resonance protection. Atrioventricular block was the most common electrocardiographic disturb. Most patients received bicameral sequential pacing although single chamber VVIR pacing was used in up to 21.8% of patients. Patients older than 80 years benefited less from physiological pacing and resynchronization therapy. CONCLUSIONS: Total use of pacemaker generators remains stable with respect to 2016. Age is the main factor that influences pacing mode selection, which could be improved in around 22% of patients. Leadless pacing continues to rise.

[Nonbacterial thrombotic endocarditis: clinicopathologic study of a necropsy series]. / Endocarditis trombótica no bacteriana: estudio clínico-patológico de una serie necrópsica.

INTRODUCTION AND OBJECTIVES: Nonbacterial thrombotic endocarditis (NBTE) is characterized by sterile platelet and fibrin deposition on cardiac valves. In this study, our aim was to investigate the clinicopathologic characteristics of patients diagnosed with NBTE at the 12 de Octubre University Hospital in Madrid, Spain. METHODS: Patients were identified by analyzing reports of autopsies carried out at the Anatomical Pathology Department of the University Hospital between 1974 and 1977 and between 1980 and 2004. RESULTS: Out of 2041 autopsies, 22 (1.08%) showed evidence of NBTE. The patients' average age was 63.04 years, and neither sex predominated. The underlying disease was an infection in 54.5% of cases, whereas 31.8% had a neoplasm, most frequently a pancreatic adenocarcinoma or renal carcinoma. In 10 cases, there was a previous valvulopathy. The mitral valve was most frequently affected by NBTE (36.5% of cases). In most cases, the cause of death was the underlying disease, though in two patients it was directly related to NBTE (9.1%). In nine cases, an embolism occurred, principally in the spleen, the kidneys or the central nervous system. Before death, there was no suspicion of NBTE in any of these cases. CONCLUSIONS: NBTE is an uncommon disease entity that occurs not only in patients with end-stage neoplastic disease, but also in those with potentially treatable diseases. Consequently, we should raise our level of awareness of this condition so that a diagnosis can be made before the patient dies and anticoagulant treatment can be started, thereby helping to improve prognosis.