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Impact of early complications on outcomes in patients with implantable cardioverter-defibrillator for primary prevention
- Source :
- Heart Rhythm, Heart Rhythm, Elsevier, 2016, 13 (5), pp.1045-1051. ⟨10.1016/j.hrthm.2015.12.046⟩, Heart Rhythm, Elsevier, 2016, In press. 〈10.1016/j.hrthm.2015.12.046〉, Heart Rhythm, 2016, 13 (5), pp.1045-1051. ⟨10.1016/j.hrthm.2015.12.046⟩
- Publication Year :
- 2016
- Publisher :
- HAL CCSD, 2016.
-
Abstract
- International audience; Background - The lifesaving benefit of implantable cardioverter-defibrillators (ICDs) has been demonstrated. Their use has increased considerably in the past decade, but related complications have become a major concern. Objective - The purpose of this study was to assess the incidence and effect on outcomes of early (≤30 days) complications after ICD implantation for primary prevention in a large French population. Methods - We analyzed data from 5539 patients from the multicenter French DAI-PP (Défibrillateur Automatique Implantable-Prévention Primaire) registry (2002-2012) who had coronary artery disease or dilated cardiomyopathy and were implanted with an ICD for primary prevention. Results - Overall, early complications occurred in 707 patients (13.5%), mainly related to lead dislodgment or hematoma (57%). Independent factors associated with occurrence of early complications were severe renal impairment (odds ratio [OR] 1.66, 95% confidence interval [CI] 1.17-2.37, P = .02), age ≥75 years (OR 1.01, 95% CI 1.00-1.02, P = .03), cardiac resynchronization therapy (OR 1.58, 95% CI 1.16-2.17, P = .01), and anticoagulant therapy (OR 1.28, 95% CI 1.02-1.61, P = .03). During a mean ± SD follow-up of 3.1 ± 2.3 years, 824 (15.8%) patients experienced ≥1 late complication (>30 days), and 782 (14.9%) patients died. After adjustment, early complications remained associated with occurrence of late complications (OR 2.15, 95% CI 1.73-2.66, P < .0001) and mortality (OR 1.70, 95% CI 1.34-2.17, P = .003). Conclusion - Early complications are common after ICD implantation for primary prevention, occurring in 1 in 7 patients, and are associated with an increased risk of late complications and overall mortality. Further studies are needed to investigate the underlying mechanisms of such associations.
- Subjects :
- Male
Pediatrics
medicine.medical_treatment
[SDV]Life Sciences [q-bio]
Coronary Artery Disease
030204 cardiovascular system & hematology
Coronary artery disease
0302 clinical medicine
Postoperative Complications
Risk Factors
Medicine
030212 general & internal medicine
Registries
education.field_of_study
Hematoma
Primary prevention
Sudden death
Incidence (epidemiology)
Incidence
Middle Aged
Implantable cardioverter-defibrillator
3. Good health
Defibrillators, Implantable
Female
France
Cardiology and Cardiovascular Medicine
Cardiomyopathy, Dilated
medicine.medical_specialty
Population
Cardiac resynchronization therapy
Electric Countershock
Risk Assessment
03 medical and health sciences
Physiology (medical)
Humans
Mortality
education
Aged
[ SDV ] Life Sciences [q-bio]
business.industry
Implantable cardiac-defibrillator
Odds ratio
medicine.disease
Survival Analysis
Equipment Failure Analysis
Death, Sudden, Cardiac
Tachycardia, Ventricular
Morbidity
Complication
business
Subjects
Details
- Language :
- English
- ISSN :
- 15563871 and 15475271
- Database :
- OpenAIRE
- Journal :
- Heart Rhythm, Heart Rhythm, Elsevier, 2016, 13 (5), pp.1045-1051. ⟨10.1016/j.hrthm.2015.12.046⟩, Heart Rhythm, Elsevier, 2016, In press. 〈10.1016/j.hrthm.2015.12.046〉, Heart Rhythm, 2016, 13 (5), pp.1045-1051. ⟨10.1016/j.hrthm.2015.12.046⟩
- Accession number :
- edsair.doi.dedup.....d196078f90ab6560dea30fbd8b761305