Ghulam Hussain Soomro, Khawar Abbas Kazmi, Azam Shafquat, Qamaruddin Roziman, Aamir Hameed Khan.
Is a routine post pace maker implantation chest x ray mandatory? data from a tertiary care hospital in a developing country.
Pak Heart J Jan ;48(4):185-9.

Objective: To determine the yield of routine chest X-Ray for ruling out major complications after implantation of permanent pacemaker. Methodology: We conducted an observational cross sectional study of patients undergoing permanent pacemaker insertion at The Aga Khan University Hospital Karachi, from October 2009 till December 2012 with average age of 70.1 and 68.8 years respectively. Population was divided into two groups including dual chamber pacemaker and single chamber pacemaker. Results: This study included 317 patients who undergone permanent pacemaker. Pneumothorax and lead displacement occurred in 0.63% and 1.57%,respectively. The pneumo-thoraxes were large and clinically significant and picked-up clinically, which could have been predicted using the lung/chest pathology in the pre implant CXR. The lead displacements were picked by symptoms and pacemaker interrogation. Conclusion: We have shown that in a tertiary care center and in the hands of experienced operators, with a good pre-implant and post implant examination and a routine device interrogation, the routine CXR can be skipped after implantation of permanent pacemaker.

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