Background: Permanent cardiac pacing is the treatment of choice for severe and symptomatic bradycardia. Patients undergoing emergency pacemaker implantation are stabilised earlier by the insertion of a temporary emergency pacing lead, and they experience more comorbidities than with planned admissions.

Aim: To identify the parameters associated with one-year mortality and in-hospital adverse events after emergency permanent pacemaker implantation.

Methods: This retrospective study analyses data from 131 consecutive emergency pacemaker implantations performed within a single centre.

Results: Cox regression analysis revealed the independent predictors of death to be: use of a temporary transvenous pacing lead (TTPL) (HR = 2.82, 95% CI 1.21–6.58, p = 0.02), age ≥ 78 years (OR = 3.01, 95% CI 1.22–7.42, p = 0.02), longer baseline QRS duration (HR = 1.02, 95% CI 1.00–1.03, p = 0.03), and history of myocardial infarction (MI) (HR = 2.43, 95% CI 1.04–5.68, p = 0.04). Twenty-six patients experienced in-hospital adverse events, such as: death (n = 6), cardiac arrest (n = 3), surgical complications (lead dislocation: n = 4, haematoma: n = 4, microperforation: n = 2), pneumonia or respiratory tract disease (n = 7), wound infection treated with antibiotics (n = 1), and subsequent MI following pacemaker implantation (n = 2). Multivariate logistic regression analysis showed that independent parameters associated with in-hospital adverse events were history of MI (OR = 5.01, 95% CI 1.88–13.3, p = 0.001) and stroke (OR = 3.51, 95% CI 1.16–10.55, p = 0.03).

Conclusions: Our results suggest that the most serious risk factors of one-year mortality related to the use of TTPL are: age ≥ 78 years, longer baseline QRS duration, and history of MI. The independent parameters associated with in-hospital adverse events were the presence of a history of MI and stroke.