Ability of CHA2DS2-VASc/R2CHA2DS2-VASc Scores to Predict Complications Related to Cardiac Implantable Electronic Devices.

Abstract

Background: Globally, the number of cardiac implantable electronic devices (CIEDs) is increasing. In our study, we aimed to investigate whether CHA₂DS₂-VASc and R₂CHA₂DS₂-VASc scores are predictive of CIED-related complications.

Methods: Our investigation was carried out with a multicenter retrospective design. Patients who underwent CIED surgery at two cardiac centers in Turkey between January 2011 and May 2023, 1676, were evaluated. The patients were divided into two groups according to their R₂CHA₂DS₂-VASc scores. Patients with R₂CHA₂DS₂-VASc ≥ 5 were included in group 1 (380 patients), and patients with R₂CHA₂DS₂-VASc < 5 (1296 patients) were included in group 2. The primary outcome was defined as the cumulative events. Each component of cumulative events, such as hematoma, pericardial effusion, pneumothorax, and infection, was also defined as a secondary outcome.

Results: The study's patient population had an average age of 62.9 ± 14 years. Pneumothorax (1.8% vs. 1.3%, p = 0.444), pericardial effusion or tamponade (0.35% vs. 0.2%, p = 0.659), and clinically significant hematoma (1.1% vs. 0.6%, p = 0.376) were comparable between the groups. Infection-related devices and cumulative events classified as primary outcomes were higher in the R₂CHA₂DS₂-VASc ≥ 5 group (6.1% vs. 1.2%, p < 0.001; 7.6% vs. 3.2%, p < 0.001, respectively). Modeling analyses showed that the CHA₂DS₂-VASc score and HT were also independent predictors of device-related infection and cumulative events.

Conclusion: In the R₂CHA₂DS₂-VASc ≥ 5 groups, infection related to the device system and cumulative events were higher. Patients with an R₂CHA₂DS₂-VASc score of 5 or more and a high CHA₂DS₂-VASc score should be evaluated more carefully regarding infection and cumulative events before and after the operation.