[Late pacemaker pocket erosion: epidemiologic analysis in a region of North-Western Italy (Piedmont and Valle d'Aosta)].

Background: Pacemaker pocket erosion is still a relevant clinical problem as it may be the cause of septicemias and/or endocarditis with consequent poor prognosis. The true incidence of this complication is rather variable in the various series of cases reported in the literature ranging between 0.9 and 5% when early infective complications are included.

Methods: In order to evaluate the real incidence of this complication we performed a retrospective analysis on the data coming from all the pacemaker implanting centers in Piedmont. Data collection forms were completed for each patient presenting this kind of complication from 1996 through 1998; the follow-up lasted for at least 36 months.

Results: In the 21 centers (81% of all implanting centers in Piedmont) in which completed data were collected, 7793 pacemaker and 289 automatic cardioverter-defibrillator (ICD) implants were performed. During the follow-up 100 cases of pacemaker pocket erosion were observed with a total incidence of 1.28% (range 0-3.1%); no cases of ICD pocket erosion were reported. Diabete mellitus was the most frequent associated disease (25% of patients), about 30% of patients were taking antiplatelet drugs. The kind of surgical procedure performed to resolve the problem was different in the various centers according to personal experience and to the various evaluations performed by each physician.

Conclusions: Our study demonstrates that the overall incidence of late pacemaker pocket erosion in our region is absolutely acceptable even in spite of relevant differences in the various implanting centers. A system of continuous monitoring with the data collection of all the performed procedures would be extremely useful to constantly check the quality level both locally and regionally.