In-Hospital Complications Associated With Reoperations of Implantable Cardioverter Defibrillators

Repeat implantable cardioverter defibrillator (ICD) procedures are increasing and may be associated with higher risks for complications. To provide more information for clinical decision making, especially in light of recent defibrillator advisories, we examined a large national cohort to characteri...

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Bibliographic Details
Published in:The American journal of cardiology 2014-08, Vol.114 (3), p.419-426
Main Authors: Steckman, David A., MD, Varosy, Paul D., MD, Parzynski, Craig S., MS, Masoudi, Frederick A., MD, MSPH, Curtis, Jeptha P., MD, Sauer, William H., MD, Nguyen, Duy T., MD
Format: Article
Language:English
Subjects:
Aged
Antibiotics
Arrhythmias, Cardiac - therapy
Cardiology
Cardiovascular
Cardiovascular disease
Cross-Sectional Studies
Defibrillators, Implantable
Female
Follow-Up Studies
Heart attacks
Heart failure
Heart surgery
Humans
Incidence
Infections
Inpatients
Length of Stay - trends
Male
Odds Ratio
Ostomy
Postoperative Complications - epidemiology
Postoperative Complications - etiology
Prosthesis Implantation - adverse effects
Registries
Reoperation - adverse effects
Retrospective Studies
Risk Factors
Transplants & implants
United States - epidemiology
Variables
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Summary:Repeat implantable cardioverter defibrillator (ICD) procedures are increasing and may be associated with higher risks for complications. To provide more information for clinical decision making, especially in light of recent defibrillator advisories, we examined a large national cohort to characterize repeat ICD procedural outcomes. Using data from the National Cardiovascular Data Registry (ICD Registry), we compared patient characteristics, reasons for ICD implantation, and associated in-hospital adverse events among 92,751 patients receiving their first device and 81,748 patients who underwent repeat procedures with (n = 31,057) and without (n = 50,691) lead involvement. Hierarchical multivariable logistic regression was used to determine the predictors of in-hospital complications. Complication rates were higher in those who underwent repeat ICD procedures with lead involvement (lead implantation or revision), compared with patients who underwent initial implants (3.2% vs 2.6%, p
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2014.05.010