Limits...
Complications after cardiac implantable electronic device implantations: an analysis of a complete, nationwide cohort in Denmark.

Kirkfeldt RE, Johansen JB, Nohr EA, Jørgensen OD, Nielsen JC - Eur. Heart J. (2013)

Bottom Line: CIED complications are more frequent than generally acknowledged.Both patient- and procedure-related predictors may identify patients with a particularly high risk of complications.This information should be taken into account both in individual patient treatment and in the planning of future organization of CIED treatment.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Aarhus University Hospital, Skejby, Denmark.

ABSTRACT

Aims: Complications after cardiac implantable electronic device (CIED) treatment, including permanent pacemakers (PMs), cardiac resynchronization therapy devices with defibrillators (CRT-Ds) or without (CRT-Ps), and implantable cardioverter defibrillators (ICDs), are associated with increased patient morbidity, healthcare costs, and possibly increased mortality.

Methods and results: Population-based cohort study in all Danish patients who underwent a CIED procedure from May 2010 to April 2011. Data on complications were gathered on review of all patient charts while baseline data were obtained from the Danish Pacemaker and ICD Register. Adjusted risk ratios (aRRs) with 95% confidence intervals were estimated using binary regression. The study population consisted of 5918 consecutive patients. A total of 562 patients (9.5%) experienced at least one complication. The risk of any complication was higher if the patient was a female (aRR 1.3; 1.1-1.6), underweight (aRR 1.5; 1.1-2.3), implanted in a centre with an annual volume <750 procedures (0-249 procedures: aRR 1.6; 1.1-2.2, 250-499: aRR 2.0; 1.6-2.7, 500-749: aRR 1.5; 1.2-1.8), received a dual-chamber ICD (aRR 2.0; 1.4-2.7) or CRT-D (aRR 2.6; 1.9-3.4), underwent system upgrade or lead revision (aRR 1.3; 1.0-1.7), had an operator with an annual volume <50 procedures (aRR 1.9; 1.4-2.6), or underwent an emergency, out-of-hours procedure (aRR 1.5; 1.0-2.3).

Conclusion: CIED complications are more frequent than generally acknowledged. Both patient- and procedure-related predictors may identify patients with a particularly high risk of complications. This information should be taken into account both in individual patient treatment and in the planning of future organization of CIED treatment.

Show MeSH

Related in: MedlinePlus

Risk of any complication according to procedure and CIED type (with 95% CI).
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4012708&req=5

EHT511F1: Risk of any complication according to procedure and CIED type (with 95% CI).

Mentions: Large differences in risk of any complication were observed between device and procedure types (Figure 1).Figure 1


Complications after cardiac implantable electronic device implantations: an analysis of a complete, nationwide cohort in Denmark.

Kirkfeldt RE, Johansen JB, Nohr EA, Jørgensen OD, Nielsen JC - Eur. Heart J. (2013)

Risk of any complication according to procedure and CIED type (with 95% CI).
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4012708&req=5

EHT511F1: Risk of any complication according to procedure and CIED type (with 95% CI).
Mentions: Large differences in risk of any complication were observed between device and procedure types (Figure 1).Figure 1

Bottom Line: CIED complications are more frequent than generally acknowledged.Both patient- and procedure-related predictors may identify patients with a particularly high risk of complications.This information should be taken into account both in individual patient treatment and in the planning of future organization of CIED treatment.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Aarhus University Hospital, Skejby, Denmark.

ABSTRACT

Aims: Complications after cardiac implantable electronic device (CIED) treatment, including permanent pacemakers (PMs), cardiac resynchronization therapy devices with defibrillators (CRT-Ds) or without (CRT-Ps), and implantable cardioverter defibrillators (ICDs), are associated with increased patient morbidity, healthcare costs, and possibly increased mortality.

Methods and results: Population-based cohort study in all Danish patients who underwent a CIED procedure from May 2010 to April 2011. Data on complications were gathered on review of all patient charts while baseline data were obtained from the Danish Pacemaker and ICD Register. Adjusted risk ratios (aRRs) with 95% confidence intervals were estimated using binary regression. The study population consisted of 5918 consecutive patients. A total of 562 patients (9.5%) experienced at least one complication. The risk of any complication was higher if the patient was a female (aRR 1.3; 1.1-1.6), underweight (aRR 1.5; 1.1-2.3), implanted in a centre with an annual volume <750 procedures (0-249 procedures: aRR 1.6; 1.1-2.2, 250-499: aRR 2.0; 1.6-2.7, 500-749: aRR 1.5; 1.2-1.8), received a dual-chamber ICD (aRR 2.0; 1.4-2.7) or CRT-D (aRR 2.6; 1.9-3.4), underwent system upgrade or lead revision (aRR 1.3; 1.0-1.7), had an operator with an annual volume <50 procedures (aRR 1.9; 1.4-2.6), or underwent an emergency, out-of-hours procedure (aRR 1.5; 1.0-2.3).

Conclusion: CIED complications are more frequent than generally acknowledged. Both patient- and procedure-related predictors may identify patients with a particularly high risk of complications. This information should be taken into account both in individual patient treatment and in the planning of future organization of CIED treatment.

Show MeSH
Related in: MedlinePlus