Ranasinghe I, Labrosciano C, Horton D, et al. - Institutional variation in risk-standardized complication rates (RSCRs) for cardiovascular implantable electronic devices (CIEDs) was examined via conducting a cohort study of 81,304 patients at 174 hospitals in Australia and New Zealand, 98 of which implanted at least 25 CIEDs during the study period. Researchers identified the occurrence of a major complication in 6,664 patients (8.2%) of the cohort, indicating the common occurrence of CIED complications. Despite higher complication rates for implantable cardioverter-defibrillators [ICDs] vs permanent pacemakers (PPMs) (10.04% vs 7.76%), 76.5% of all complications were attributable to PPMs (5098 vs 1566 for ICDs). Hospitals varied in CIED complications, suggesting institutional variation in CIED care quality. The median RSCR of 8.1% was observed among hospitals that implanted at least 25 CIEDs; however, rates varied from 5.3% to 14.3%; there were 22 hospitals that had RSCRs significantly different from the national average.