Peri and Post-Procedural Complications of Permanent Pacemaker Implantation: Experience from an Indian Tertiary Care Centre

Background: Permanent Pacemaker Implantation (PPI) is a standard intervention for symptomatic bradyarrhythmias. Although the procedure is generally safe, peri- and post-procedural complications may affect outcomes, especially in patients with comorbidities. Objective: To evaluate the incidence, spectrum and clinical impact of complications associated with PPI in a tertiary care setting. Methods: This retrospective study included 375 patients who underwent PPI between [March 2022-March 2025] at a tertiary care centre. Data regarding patient demographics, comorbidities, procedural details and peri/post-procedural complications were extracted from institutional records. Outcomes were analysed using descriptive statistics. Results: Of 375 patients, 363 (96.8%) had an uneventful recovery. Complications were observed in 12 patients (3.2%). The most frequent was pacemaker pocket infection (n=4), followed by pneumothorax (n=2), pericardial effusion (n=2), atrial fibrillation (n=1), ventricular fibrillation (n=1), lead displacement (n=1) and cardiorespiratory arrest (n=1). No re-implantation procedures were required and no procedure-related mortality was reported. All complications were managed successfully with appropriate medical or minor interventional measures. Conclusion: PPI remains a safe and effective intervention with a low complication rate in routine clinical practice. Most complications were non-fatal and manageable. These findings highlight the need for meticulous technique, careful patient monitoring and early identification of adverse events to maintain optimal outcomes.