MORTALITY OF PATIENTS WITH IMPLANTED PACEMAKER: LONG-TERM FOLLOW-UP DATA FROM CZECH NATIONAL PACEMAKER REGISTRY (REPACE).

Aim: The aim is the long-term continuous monitoring of patients with an implanted pacemaker (PM) regarding real mortality and morbidity in relation to the standard population without PM, to predict the development of procedures and costs of care in the next ten years.
Methodology: The analysis is based on data managed by the Institute of Health Information and Statistics of the Czech Republic (ÚZIS ČR), which are collected within the framework of NZIS and national health registers. 
Results: The analysis is performed on a population sample of 82,791 patients who underwent PM implantation for symptomatic bradycardia with standard indications according to the ESC guidelines. In 2020, there was a year-on-year decrease of 6%, in connection with the COVID-19 pandemic, increased mortality and the limitation of care provided. The annual share of reimplantations in the total number of performed procedures varies between 24% and 30%. In the years 2010-2021, almost 114 thousand pacemakers were implanted, of which 27.9% were single-chamber, 67.4% were double-chamber , and 4.6% were biventricular. A higher proportion of pacemakers are implanted in men (56.9% vs. 43.1% in women). This share is increasing over time: in 2010, the share of men was 55.3%, in 2021 it will be 57.8%. The average age of a patient at the time of initial pacemaker implantation is 76 years (75 years for men, 77 years for women). From 2010 to 2021, the average age of patients at primary implantation increased by 1 year from 75.3 years to 76.3 years. Patients with primary PM implantation in the years 2010–2021 (N = 82,791) according to the age of the patient at the time of the procedure - the length of survival is evaluated using the Kaplan-Meier method. . 5-year relative survival is 88.6% (overall survival: 60.6%), 10-year relative survival is 75.9% (overall survival: 32.7%).