Arun Raghav Mahankali Sridhar1, Vivek Yarlagadda1, Madhu Reddy Yeruva1, Arun Kanmanthareddy1, Ajay Vallakati2, Buddhadeb Dawn1, Dhanunjaya Lakkireddy3. 1. Division of Cardiovascular Diseases, Cardiovascular Research Institute, The University of Kansas Hospital & Medical Center, Kansas City, KS, USA. 2. Metro Health Medical Center, Case Western Reserve University, Cleveland, OH, USA. 3. Division of Cardiovascular Diseases, Cardiovascular Research Institute, The University of Kansas Hospital & Medical Center, Kansas City, KS, USA dlakkireddy@kumc.edu.
Abstract
AIMS: Pocket haematoma is a common complication following pacemaker implantation. Impact of this complication on post-procedural outcomes has previously not been systematically studied. We sought to identify the incidence of pocket haematoma after a de novo pacemaker and cardiac resynchronization therapy (CRT) device implantation and evaluate its impact on the hospital outcomes using a large all-payer national inpatient database. METHODS AND RESULTS: Data from Nationwide Inpatient Sample 2010 was queried to identify all primary implantations of single chamber, dual chamber pacemakers, and biventricular devices during the year 2010 using the appropriate ICD-9 codes. Patients who experienced a procedure-related haematoma during the hospital stay were identified. Of a total of 78,751 primary pacemaker implantations in the year 2010, 1677 (2.1%) of the implantations were complicated by a pocket haematoma. Higher age groups, more complex pacemaker types (BiV > dual chamber > single chamber), and comorbidities such as congestive heart failure and coagulopathy were associated with an increased risk of pocket haematoma formation post-pacemaker implantation. Patients who developed a pocket haematoma had a longer length of stay (8.7 vs. 4.8 days, P < 0.001), higher hospitalization costs ($48,815 vs. $34,324, P < 0.001) and higher in-hospital mortality (2.0 vs. 0.7%, P < 0.001) compared with patients who did not develop a haematoma. CONCLUSIONS: Haematoma is a relatively common complication associated with pacemaker implantation; however, it adversely impacts in-hospital outcomes. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: Pocket haematoma is a common complication following pacemaker implantation. Impact of this complication on post-procedural outcomes has previously not been systematically studied. We sought to identify the incidence of pocket haematoma after a de novo pacemaker and cardiac resynchronization therapy (CRT) device implantation and evaluate its impact on the hospital outcomes using a large all-payer national inpatient database. METHODS AND RESULTS: Data from Nationwide Inpatient Sample 2010 was queried to identify all primary implantations of single chamber, dual chamber pacemakers, and biventricular devices during the year 2010 using the appropriate ICD-9 codes. Patients who experienced a procedure-related haematoma during the hospital stay were identified. Of a total of 78,751 primary pacemaker implantations in the year 2010, 1677 (2.1%) of the implantations were complicated by a pocket haematoma. Higher age groups, more complex pacemaker types (BiV > dual chamber > single chamber), and comorbidities such as congestive heart failure and coagulopathy were associated with an increased risk of pocket haematoma formation post-pacemaker implantation. Patients who developed a pocket haematoma had a longer length of stay (8.7 vs. 4.8 days, P < 0.001), higher hospitalization costs ($48,815 vs. $34,324, P < 0.001) and higher in-hospital mortality (2.0 vs. 0.7%, P < 0.001) compared with patients who did not develop a haematoma. CONCLUSIONS: Haematoma is a relatively common complication associated with pacemaker implantation; however, it adversely impacts in-hospital outcomes. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Nishaki Kiran Mehta; Katerina Morgaenko; David Haines; Edward Rojas-Pena; Brittney Heard; Rohit Malhotra; Andrew Darby; James Michael Mangrum; Pamela Mason; Christopher Campbell; Kenneth Bilchick Journal: J Arrhythm Date: 2021-01-19
Authors: John de Heide; Marisa van der Graaf; Marijn J Holl; Rohit E Bhagwandien; Dominic A M J Theuns; André de Wit; Felix Zijlstra; Tamas Szili-Torok; Mattie J Lenzen; Sing-Chien Yap Journal: Int J Cardiol Heart Vasc Date: 2022-03-16