BACKGROUND AND PURPOSE: Complex cardiac pacing with either an implantable cardiovertor defibrillator (ICD) or a biventricular pacemaker with pacing only (CRT-P) or biventricular pacemaker with implantable cardiovertor defibrillator (CRT-D) plays an important role in the management of patients with heart failure. However, device implantation is associated with rare but significant complications which may limit the number of centres offering this treatment. The aim of this study is to define procedural success and complication rates associated with implantation of complex implantable cardiac devices in a district general hospital. METHODS AND SUBJECTS: The pacing records of all the patients who underwent complex cardiac pacing (ICD, CRT-P and CRT-D) between January 2010 and December 2011 were reviewed. Information on clinical characteristics, pacing indications, venous access, implantation data, lead stability at follow-up, and procedure-related complications were obtained. RESULTS: A total of 151 devices (60 CRT-Ds, 55 CRT-Ps and 36 ICDs), were implanted between January 2010 and December 2011 with a median follow-up of 12 months. Overall transvenous procedural success rate was 99.3%. 14 (9.3%) out of the 151 patients suffered a complication. There were no procedure-related deaths, and lead displacement (5.3%) was the most common complication. Other complications included pocket haematoma and phrenic nerve stimulation (1.3% and 3.4%, respectively). There were no cases of pneumothorax, cardiac tamponade, device-related infection, symptomatic venous thrombosis and stroke. Lead thresholds, in particular that of the left ventricular lead, remained stable during the follow-up period indicating persistent delivery of cardiac resynchronisation therapy in the group receiving CRT systems. CONCLUSIONS: In the presence of necessary clinical expertise, complex cardiac devices can be implanted successfully and with a high degree of safety in the setting of a district general hospital.
BACKGROUND AND PURPOSE: Complex cardiac pacing with either an implantable cardiovertor defibrillator (ICD) or a biventricular pacemaker with pacing only (CRT-P) or biventricular pacemaker with implantable cardiovertor defibrillator (CRT-D) plays an important role in the management of patients with heart failure. However, device implantation is associated with rare but significant complications which may limit the number of centres offering this treatment. The aim of this study is to define procedural success and complication rates associated with implantation of complex implantable cardiac devices in a district general hospital. METHODS AND SUBJECTS: The pacing records of all the patients who underwent complex cardiac pacing (ICD, CRT-P and CRT-D) between January 2010 and December 2011 were reviewed. Information on clinical characteristics, pacing indications, venous access, implantation data, lead stability at follow-up, and procedure-related complications were obtained. RESULTS: A total of 151 devices (60 CRT-Ds, 55 CRT-Ps and 36 ICDs), were implanted between January 2010 and December 2011 with a median follow-up of 12 months. Overall transvenous procedural success rate was 99.3%. 14 (9.3%) out of the 151 patients suffered a complication. There were no procedure-related deaths, and lead displacement (5.3%) was the most common complication. Other complications included pocket haematoma and phrenic nerve stimulation (1.3% and 3.4%, respectively). There were no cases of pneumothorax, cardiac tamponade, device-related infection, symptomatic venous thrombosis and stroke. Lead thresholds, in particular that of the left ventricular lead, remained stable during the follow-up period indicating persistent delivery of cardiac resynchronisation therapy in the group receiving CRT systems. CONCLUSIONS: In the presence of necessary clinical expertise, complex cardiac devices can be implanted successfully and with a high degree of safety in the setting of a district general hospital.
Authors: William T Abraham; Westby G Fisher; Andrew L Smith; David B Delurgio; Angel R Leon; Evan Loh; Dusan Z Kocovic; Milton Packer; Alfredo L Clavell; David L Hayes; Myrvin Ellestad; Robin J Trupp; Jackie Underwood; Faith Pickering; Cindy Truex; Peggy McAtee; John Messenger Journal: N Engl J Med Date: 2002-06-13 Impact factor: 91.245
Authors: Paul W X Foley; Clara E Addison; Stephanie B Whinney; Kiran Patel; David Cunningham; Michael P Frenneaux; Francisco Leyva Journal: Pacing Clin Electrophysiol Date: 2009-03 Impact factor: 1.976
Authors: M D Flather; S Yusuf; L Køber; M Pfeffer; A Hall; G Murray; C Torp-Pedersen; S Ball; J Pogue; L Moyé; E Braunwald Journal: Lancet Date: 2000-05-06 Impact factor: 79.321
Authors: Arthur J Moss; Wojciech Zareba; W Jackson Hall; Helmut Klein; David J Wilber; David S Cannom; James P Daubert; Steven L Higgins; Mary W Brown; Mark L Andrews Journal: N Engl J Med Date: 2002-03-19 Impact factor: 91.245
Authors: E Kevin Heist; Dali Fan; Theofanie Mela; Daniel Arzola-Castaner; Vivek Y Reddy; Moussa Mansour; Michael H Picard; Jeremy N Ruskin; Jagmeet P Singh Journal: Am J Cardiol Date: 2005-09-01 Impact factor: 2.778
Authors: Uwe K H Wiegand; Dominik LeJeune; Frank Boguschewski; Hendrik Bonnemeier; Frank Eberhardt; Heribert Schunkert; Frank Bode Journal: Chest Date: 2004-10 Impact factor: 9.410
Authors: John G F Cleland; Jean-Claude Daubert; Erland Erdmann; Nick Freemantle; Daniel Gras; Lukas Kappenberger; Luigi Tavazzi Journal: N Engl J Med Date: 2005-03-07 Impact factor: 91.245
Authors: J W M van Eck; N M van Hemel; P Zuithof; J P M van Asseldonk; T L H M Voskuil; D E Grobbee; K G M Moons Journal: Europace Date: 2007-06-07 Impact factor: 5.214
Authors: Michiel Hulleman; Jocelyn Berdowski; Joris R de Groot; Pascal F H M van Dessel; C Jan Willem Borleffs; Marieke T Blom; Abdenasser Bardai; Carel C de Cock; Hanno L Tan; Jan G P Tijssen; Rudolph W Koster Journal: Circulation Date: 2012-08-06 Impact factor: 29.690