Early Mobilization After Pacemaker Implantation.

BACKGROUND The increasing use of cardiac implantable electronic devices (CIED) is leading to a rise in procedure-related complications.

OBJECTIVE This trial aimed to assess the safety and feasibility of early mobilization and the possibility of same-day discharge following permanent pacemaker implantation.

METHODS 200 patients were enrolled from 3/2019 to 12/2023 in this trial. Participants were randomly assigned to the Early Mobilization arm with 4 h of post-procedure bed rest or the Late Mobilization arm with 16-24 h of post-procedure bed rest. Primary endpoints include a composite of common complications: hematoma, major bleeding, wound infections, pneumothorax, and lead dislodgement. Secondary endpoints compared the incidence of individual complications from primary endpoints and changes in the technical parameters of the CIED between the two groups. Follow-ups were at 1 and 6 months.

RESULTS Two hundred patients were enrolled, 191 (95.5%) had the 6-month follow-up. About 150 patients received a dual lead device, and 50 received a single lead device. There were no significant differences in primary composite complications (EaM vs. LaM; four cases, 4% vs. seven cases, 7%; p = 0.548). There were no significant differences in secondary endpoints EaM vs. LaM; atrial lead dislodgement (2 vs. 2), ventricular lead dislodgement (0 vs. 0), and wound infection (1 vs. 0), respectively. Technical parameters remained stable in both arms without any significant differences, for example, a drop in sensing or an increase in the stimulation threshold.

CONCLUSION The early mobilization protocol is safe, and the incidence of complications is no higher than that of late mobilization.