Sörmland Skåne Stockholm Gävleborg Kronoberg Halland SWEDEN Gotland Dalarna Örebro Västra Götaland Jönköping Värmland Kalmar Uppsala Blekinge 1 Jämtland 1 Norrbotten 1 Västerbotten 1 Västernorrland 1 Västmanland 1 Östergötland 1
3.03 3.06 3.26 3.56 3.59 3.71 3.73 4.35 4.49 4.55 4.92 5.49 5.60 6.44 8.35
0 2009
Figure 99
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Complication rates below 3 percent are seen as a result of incomplete reporting
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12 Percent
Percentage of patients who experienced complications within one year after pacemaker treatment, 2010. Source. Swedish ICD/Pacemaker Registry
99 Complications after Pacemaker Implantation Slow or irregular heartbeat can lead to dizziness, fainting spells or sudden death. A pacemaker is implanted to help restore a sufficiently rapid pulse or regular rhythm. Approximately 6 300 Swedes, with men averaging 75 years of age and women 78, receive their first pacemaker each year. Almost 50 000 Swedes currently have pacemakers. Pacemaker surgery is typically uncomplicated and lasts for an hour. Patients are normally hospitalised, but day-case surgery may be an option. Nevertheless, the procedure is associated with the risk of complications. Thus, the frequency of complications is an obvious indicator for monitoring quality. The Swedish ICD/Pacemaker Registry is the source of the data. Information about insertion of standard pacemakers, implantable cardioverter defibrillators (ICDs) and cardiac resynchronisation therapy (CRT) devices is reported to the register. All 43 clinics that implant pacemakers report to the register. The participation rate is very good at the individual level. A comparison for 2006 found the rate to be 95 per cent, which is better than the National Patient Register. The indicator shows the percentage of patients who experienced complications after initial implantation, replacement or correction of a standard pacemaker. The location of the clinic rather than where the patient was living formed the basis of county reporting. 208
QUALITY AND EFFICIENCY IN SWEDISH HEALTH CARE 2012