Skip to main content
Log in

Implantation of a cardiac pacemaker –

Comparison of subjective stress and mood between in- and outpatients

  • ORIGINAL PAPER
  • Published:
Clinical Research in Cardiology Aims and scope Submit manuscript

Summary

Background

An increasing number of cardiac pacemaker implantations are performed in the outpatient setting. Studies have compared costs and complication rates of outpatient versus inpatient pacemaker implantations but little is known on the subjective experience of the procedure by patients.

Methods

Between 1999 and 2000, patients were prospectively included at admission to a teaching hospital and to an outpatient clinic for elective pacemaker implantations in Cottbus, Germany. Perioperative stress was assessed prior to the operation as well as on the day after the implantation and 3–4 days later. We used three validated questionnaires to assess stress: the “Short Questionnaire of Current Stress”, the “Multidimensional Mood Questionnaire”, and the “List of Mood and Emotion Descriptors”.

Results

A total of 138 patients were enrolled. Of those, 74 patients (mean age: 71±12 years; 45% female) had an outpatient implantation compared to 64 patients in the hospital setting (mean age: 73±12 years; 53% female). Stress was highest immediately prior to the implantation and lowest on day 3–4 in both groups. Inpatients were significantly less likely to experience agitation compared to outpatients (P=0.002). On the other hand, outpatients reported a significantly higher activity level. There were no differences regarding any of the other dimensions between the two groups.

Conclusion

Both in- and outpatient cardiac pacemaker implantation are associated with increased preoperative stress. In both groups, however, stress decreases rapidly following the intervention. In the referral of patients, sociodemographic factors such as area of residence will probably play the key role.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Trohman RG, Kim MH, Pinski SL (2004) Cardiac pacing: the state of the art. Lancet 9446:1701–1719

    Article  Google Scholar 

  2. Mond HG, Irwin M, Morillo C, Ector H (2004) The world survey of cardiac pacing and cardioverter defibrillators: calendar year 2001. Pacing Clin Electrophysiol 7:955–964

    Article  Google Scholar 

  3. Markewitz A (2002) Jahresbericht 2000/2001 des Deutschen Zentralregisters Herzschrittmacher. Herzschr Elektrophys 13:242–257

    Article  Google Scholar 

  4. Danish Pacemaker Register (2006) Danish pacemaker and ICD statistics 2004. http://www.pacemaker.dk/stat.2004pdf

  5. Haywood GA, Jones SM, Camm AJ, Ward DE (1991) Day case permanent pacing. Pacing Clin Electrophysiol 5 Pt 1:773–777

    Article  Google Scholar 

  6. Zegelman M, Kreuzer J, Wagner R (1986) Ambulatory pacemaker surgery– medical and economical advantages. Pacing Clin Electrophysiol 6 Pt 2:1299–1303

    Article  Google Scholar 

  7. Zegelman M, Kreuzer J (1990) Ambulante Schrittmacherimplantation: Ein Update. Herzschrittmacher 10:8–12

    Google Scholar 

  8. Steinke TM, Josefiak K, Frackenpohl H (1994) Ambulante Schrittmacherimplantationen – Eigene Ergebnisse, medizinische, wirtschaftliche und juristische Aspekte im Lichte der “Strukturänderung”. Herzschr Elektrophys 5:67–72

    Google Scholar 

  9. Schmitt CG (1990) Ambulante Herzschrittmacherimplantation in der Praxis des niedergelassenen Chirurgen. Herzschrittmacher 10:13–15

    Google Scholar 

  10. Schmitt CG, Schmitz-Salue C (1992) Fünf Jahre Herzschrittmachertherapie in der Praxis des niedergelassenen Chirurgen. Herzschrittmacher 12:37–39

    Google Scholar 

  11. Bub E, Balzer S (1987) Herzschrittmacherimplantation in der Praxis: Vorgehen und Erfahrungen. Herzschrittmacher 7:171–176

    Google Scholar 

  12. Belott PH (1987) Outpatient pacemaker procedures. Int J Cardiol 2:169–176

    Article  Google Scholar 

  13. Irwin ME, Gulamhusein SS, Senaratne MP, St Clair WR (1994) Outcomes of an ambulatory cardiac pacing program: indications, risks, benefits, and outcomes. Pacing Clin Electrophysiol 11 Pt 2:2027–2031

    Article  Google Scholar 

  14. Haywood GA, Jones SM, Camm AJ, Ward DE (1991) Day case permanent pacing. Pacing Clin Electrophysiol 5 Pt 1:773–777

    Article  Google Scholar 

  15. Zegelman M, Kreuzer J, Wagner R (1986) Ambulatory pacemaker surgery– medical and economical advantages. Pacing Clin Electrophysiol 6 Pt 2:1299–1303

    Article  Google Scholar 

  16. Haywood GA, Jones SM, Camm AJ, Ward DE (1991) Day case permanent pacing. Pacing Clin Electrophysiol 5 Pt 1:773–777

    Article  Google Scholar 

  17. Irwin ME, Gulamhusein SS, Senaratne MP, St Clair WR (1994) Outcomes of an ambulatory cardiac pacing program: indications, risks, benefits, and outcomes. Pacing Clin Electrophysiol 11 Pt 2:2027–2031

    Article  Google Scholar 

  18. Villalba S, Roda J, Quesada A, Palanca V, Zaragoza C, Bataller E, Velasco JA (2004) [Retrospective study of patients who undergo pacemaker implantation in short-stay ambulatory surgery. Long-term follow-up and cost analysis]. Rev Esp Cardiol 3:234–240

    Article  Google Scholar 

  19. Haywood GA, Jones SM, Camm AJ, Ward DE (1991) Day case permanent pacing. Pacing Clin Electrophysiol 5 Pt 1:773–777

    Article  Google Scholar 

  20. Blacher RS, Basch SH (1970) Psychological aspects of pacemaker implantation. Arch Gen Psychiatry 4:319–323

    Google Scholar 

  21. Alt E, Müller H, Wirtzfeld A (1983) Schrittmachertherapie aus der Sicht des Patienten. Med Klin 78:598–600

    Google Scholar 

  22. Schuppel R (1995) [Psychosomatic aspects of pacemaker therapy]. Ther Umsch 2:150–154

    Google Scholar 

  23. Price H, Obel IW, Millar RN (1980) Psychosocial aspects of cardiac pacing. S Afr Med J 15:580–582

    Google Scholar 

  24. Aydemir O, Ozmen E, Kuey L, Kultur S, Yesil M, Postaci N, Bayata S (1997) Psychiatric morbidity and depressive symptomatology in patients with permanent pacemakers. Pacing Clin Electrophysiol 6:1628–1632

    Article  Google Scholar 

  25. Greene WA, Moss AJ (1969) Psychosocial factors in the adjustment of patients with permanently implanted cardiac pacemakers. Ann Intern Med 5:897–902

    Google Scholar 

  26. Luderitz B, Wolpert C (2003) The patient’s informed consent for pacemakers and ICD implantation: how to write and how to explain it. Z Kardiol 5:377–383

    Article  Google Scholar 

  27. Müller B, Basler HD (1993) Kurzfragebogen zur aktuellen Beanspruchung. Beltz Test GmbH, Weinheim

  28. Steyer R, Schwenkmezger P, Notz P, Eid M (1997) Der Mehrdimensionale Befindlichkeitsfragebogen. Hogrefe Verlage für Psychologie, Göttingen

  29. Janke W, Debus G (1978) Die Eigenschaftswörterliste. Hogrefe Verlage für Psychologie, Göttingen

  30. Haywood GA, Jones SM, Camm AJ, Ward DE (1991) Day case permanent pacing. Pacing Clin Electrophysiol 5 Pt 1:773–777

    Article  Google Scholar 

  31. Blacher RS, Basch SH (1970) Psychological aspects of pacemaker implantation. Arch Gen Psychiatry 4:319–323

    Google Scholar 

  32. Schuppel R (1995) [Psychosomatic aspects of pacemaker therapy]. Ther Umsch 2:150–154

    Google Scholar 

  33. Blacher RS, Basch SH (1970) Psychological aspects of pacemaker implantation. Arch Gen Psychiatry 4:319–323

    Google Scholar 

  34. Haywood GA, Jones SM, Camm AJ, Ward DE (1991) Day case permanent pacing. Pacing Clin Electrophysiol 5 Pt 1:773–777

    Article  Google Scholar 

  35. Schuppel R (1995) [Psychosomatic aspects of pacemaker therapy]. Ther Umsch 2:150–154

    Google Scholar 

  36. Haywood GA, Jones SM, Camm AJ, Ward DE (1991) Day case permanent pacing. Pacing Clin Electrophysiol 5 Pt 1:773–777

    Article  Google Scholar 

  37. Zegelman M, Kreuzer J, Wagner R (1986) Ambulatory pacemaker surgery– medical and economical advantages. Pacing Clin Electrophysiol 6 Pt 2:1299–1303

    Article  Google Scholar 

  38. Haywood GA, Jones SM, Camm AJ, Ward DE (1991) Day case permanent pacing. Pacing Clin Electrophysiol 5 Pt 1:773–777

    Article  Google Scholar 

  39. Villalba S, Roda J, Quesada A, Palanca V, Zaragoza C, Bataller E, Velasco JA (2004) [Retrospective study of patients who undergo pacemaker implantation in short-stay ambulatory surgery. Long-term follow-up and cost analysis]. Rev Esp Cardiol 3:234–240

    Article  Google Scholar 

  40. Villalba S, Roda J, Quesada A, Palanca V, Zaragoza C, Bataller E, Velasco JA (2004) [Retrospective study of patients who undergo pacemaker implantation in short-stay ambulatory surgery. Long-term follow-up and cost analysis]. Rev Esp Cardiol 3:234–240

    Article  Google Scholar 

  41. Wietholt D, Kopfer T, Paul K, Gassler A, Bruch L, Kleber FX (2003) [Structure of the Australian system of ‘Diagnosis Related Groups’ regarding cardiovascular diseases and corresponding cost weights in Germany]. Z Kardiol 8:619–626

    Article  Google Scholar 

  42. Haywood GA, Jones SM, Camm AJ, Ward DE (1991) Day case permanent pacing. Pacing Clin Electrophysiol 5 Pt 1:773–777

    Article  Google Scholar 

  43. Benesch L (1998) [Ambulatory vs. inpatient rehabilitation after established myocardial infarct – contra ambulatory rehabilitation]. Z Kardiol 87 (Suppl 2):225–227

    Article  PubMed  Google Scholar 

  44. Rost R (1998) [Ambulatory vs. inpatient rehabilitation after established myocardial infarct–pro ambulatory rehabilitation]. Z Kardiol 87 (Suppl 2): 222–224

    Article  PubMed  Google Scholar 

  45. Oliva F, Gronda E, Frigerio M, Comerio G, Manglavacchi M, Masciocco G, Andreuzzi B (1999) [Outpatient intermittent dobutamine therapy in congestive heart failure]. Z Kardiol 87 (Suppl 2):S28–S32

    Article  Google Scholar 

  46. Cohen J (1988) Statistical power analysis for the behavioural sciences. Lawrence Erlbaum Associates: Hillsdale, NJ

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jacqueline Müller-Nordhorn DPH.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Müller-Nordhorn, J., Schüler, G., Roll, S. et al. Implantation of a cardiac pacemaker –. Clin Res Cardiol 95, 539–546 (2006). https://doi.org/10.1007/s00392-006-0426-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00392-006-0426-3

Key words

Navigation