Comparison of ICD implantation in obese and nonobese patients.

BACKGROUND: Implantable defibrillator (ICD) therapy improves mortality in patients at risk for sudden cardiac death. Obese patients pose challenges during ICD implantation and may have an increased risk of procedure-related complications. The comparison of acute procedural success and safety of ICD implantation in obese and nonobese patients has not been previously reported.
METHODS: A total of 181 patients underwent ICD implantation at a single institution. Obesity was defined as a body mass index (BMI) greater than or equal to 30 kg/m(2) . Acute safety and efficacy data were collected and analyzed from a prospectively maintained database, with retrospective chart review, as required.
RESULTS: Among the 181 patients, 58 (32.0%) were obese. Mean BMI was 36.7 ± 6.3 kg/m(2) among obese patients and was 24.6 ± 3.1 kg/m(2) among nonobese patients (P < 0.001). Successful ICD implantation occurred in 58 of 58 (100%) obese patients and 122 of 123 (99.2%) nonobese patients (P = 1.0). A complication was observed in three of 58 (5.2%) obese patients and in seven of 123 (5.7%) nonobese patients (P = 1.0). Similarly, there was no difference in acute procedural success and safety in patients receiving a cardiac resynchronization therapy (CRT)-ICD.
CONCLUSIONS: Acute success and safety of ICD implantation is similar in both obese and nonobese patients. This finding extended to patients treated with a CRT-ICD and among patients with extreme obesity. Obesity should probably not be a factor in determining whether a patient is a candidate for ICD implantation. ©2013, The Authors. Journal compilation ©2013 Wiley Periodicals, Inc.