Impact of Procedural Aspects on Early Complications After Permanent Cardiac Implantable Device Implantations.

IF 1.7 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Pace-Pacing and Clinical Electrophysiology Pub Date : 2025-02-01 Epub Date: 2024-12-24 DOI:10.1111/pace.15124
Joanna Popiolek-Kalisz, Tomasz Chrominski, Marcin Szczasny, Piotr Błaszczak
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引用次数: 0

Abstract

Background: Cardiac implantable devices (CIED) such as pacemakers, implantable cardioverter-defibrillators, or cardiac resynchronization devices are implanted in selected patients with bradyarrhythmia and advanced heart failure. The invasive character of these procedures poses a risk of early complications such as pneumothorax, bleeding, infections, or dislocations.

Aims: There are no available data that analyzed the impact of the organization of procedures on the early complications risk after permanent pacing procedures. The aim of this study was to investigate if organizational aspects can impact early complications risk in CIED implantations.

Methods: This retrospective study analyzed the medical records of 1673 patients who underwent CIED implantation at the Department of Cardiology of Cardinal Wyszynski Hospital in the years 2016-2020 (before the conduction system pacing era).

Results: The regression analysis revealed the predictive value of the number of leads on complication risk overall (β = 0.65, p < 0.001). Even though the significant differences in complications count were also observed for the consecutive days of the week (p = 0.002) and procedure order within the same day (p = 0.01), the regression analysis did not confirm their predictive value on complications' risk. However, the subgroup analysis regarding the device type revealed the significant predictive value of procedure order on complications in the single-chamber pacemaker subgroup (β = 1.10, p = 0.01). Moreover, the subgroup analysis confirmed the predictive value of the number of leads on pneumothorax (β = 0.89, p = 0.04) and dislocation (β = 0.67, p = 0.01), age of the patient, and the assist with the less experienced operator on hemopericardium (β = 0.11, p = 0.02, and β = 2.34, p = 0.04, respectively).

Conclusion: The study showed that the number of leads is the main factor of early complications after CIED implantations. In the simplest devices such as single-chamber pacemakers, the order of the procedure within the same day can also play a role in early complications risk.

程序方面对永久性心脏植入后早期并发症的影响。
背景:心脏植入式装置(CIED),如起搏器、植入式心律转复除颤器或心脏再同步装置被植入慢速心律失常和晚期心力衰竭患者。这些手术的侵入性特点带来了早期并发症的风险,如气胸、出血、感染或脱位。目的:目前尚无数据分析手术安排对永久性起搏术后早期并发症风险的影响。本研究的目的是调查组织因素是否会影响CIED植入的早期并发症风险。方法:回顾性分析2016-2020年(传导系统起搏时代前)在Cardinal Wyszynski医院心内科行CIED植入术的1673例患者病历。结果:回归分析显示导联数对并发症风险的总体预测价值(β = 0.65, p < 0.001)。尽管在连续几天的并发症数量(p = 0.002)和同一天内的手术顺序(p = 0.01)上也观察到显著差异,但回归分析并不能证实它们对并发症风险的预测价值。然而,关于器械类型的亚组分析显示,单室起搏器亚组手术顺序对并发症有显著的预测价值(β = 1.10, p = 0.01)。此外,亚组分析证实了导联数对气胸(β = 0.89, p = 0.04)和脱位(β = 0.67, p = 0.01)、患者年龄和辅助经验不足的心包手术(β = 0.11, p = 0.02, β = 2.34, p = 0.04)的预测价值。结论:导联数是影响CIED植入术早期并发症的主要因素。在单室起搏器等最简单的设备中,同一天内的手术顺序也可以在早期并发症风险中发挥作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Pace-Pacing and Clinical Electrophysiology
Pace-Pacing and Clinical Electrophysiology 医学-工程:生物医学
CiteScore
2.70
自引率
5.60%
发文量
209
审稿时长
2-4 weeks
期刊介绍: Pacing and Clinical Electrophysiology (PACE) is the foremost peer-reviewed journal in the field of pacing and implantable cardioversion defibrillation, publishing over 50% of all English language articles in its field, featuring original, review, and didactic papers, and case reports related to daily practice. Articles also include editorials, book reviews, Musings on humane topics relevant to medical practice, electrophysiology (EP) rounds, device rounds, and information concerning the quality of devices used in the practice of the specialty.
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