BACKGROUND: While outcomes after de novo cardiac resynchronization therapy (CRT) implantations have been reported, there are limited data on CRT upgrade procedures. OBJECTIVE: The purpose of this study was to examine trends and in-hospital outcomes of patients undergoing CRT upgrade procedures by using a large national inpatient database. METHODS: Using the National Inpatient Sample database, we identified all patients undergoing CRT upgrade and de novo CRT implants between 2003 and 2013. Rates of in-hospital adverse events such as death, cardiac perforation, pneumothorax, and lead revision were examined. Multivariate regression analysis was performed to compare outcomes after CRT upgrade and those after de novo CRT implant procedures. RESULTS: Between 2003 and 2013, 19,546 CRT upgrade procedures and 464,246 de novo CRT implants were recorded. Rates of in-hospital mortality of patients undergoing CRT upgrade were significantly higher than those of patients undergoing de novo CRT implant (1.9% vs 0.8%; P < .001). Compared with de novo CRT implants, CRT upgrades were independently associated with increased mortality (adjusted odds ratio [OR] 1.91; 95% confidence interval [CI] 1.67-2.19; P < .001), cardiac perforation (OR 3.20; 95% CI 2.71-3.77; P < .001), and need for lead revision (OR 2.09; 95% CI 1.88-2.3; P < .001). CONCLUSION: In a large national inpatient cohort, CRT upgrade procedures were associated with higher rates of in-hospital mortality and procedural complications as compared with de novo CRT implants.
BACKGROUND: While outcomes after de novo cardiac resynchronization therapy (CRT) implantations have been reported, there are limited data on CRT upgrade procedures. OBJECTIVE: The purpose of this study was to examine trends and in-hospital outcomes of patients undergoing CRT upgrade procedures by using a large national inpatient database. METHODS: Using the National Inpatient Sample database, we identified all patients undergoing CRT upgrade and de novo CRT implants between 2003 and 2013. Rates of in-hospital adverse events such as death, cardiac perforation, pneumothorax, and lead revision were examined. Multivariate regression analysis was performed to compare outcomes after CRT upgrade and those after de novo CRT implant procedures. RESULTS: Between 2003 and 2013, 19,546 CRT upgrade procedures and 464,246 de novo CRT implants were recorded. Rates of in-hospital mortality of patients undergoing CRT upgrade were significantly higher than those of patients undergoing de novo CRT implant (1.9% vs 0.8%; P < .001). Compared with de novo CRT implants, CRT upgrades were independently associated with increased mortality (adjusted odds ratio [OR] 1.91; 95% confidence interval [CI] 1.67-2.19; P < .001), cardiac perforation (OR 3.20; 95% CI 2.71-3.77; P < .001), and need for lead revision (OR 2.09; 95% CI 1.88-2.3; P < .001). CONCLUSION: In a large national inpatient cohort, CRT upgrade procedures were associated with higher rates of in-hospital mortality and procedural complications as compared with de novo CRT implants.
Authors: Annamaria Kosztin; Mate Vamos; Daniel Aradi; Walter Richard Schwertner; Attila Kovacs; Klaudia Vivien Nagy; Endre Zima; Laszlo Geller; Gabor Zoltan Duray; Valentina Kutyifa; Bela Merkely Journal: Heart Fail Rev Date: 2018-01 Impact factor: 4.214
Authors: Mariana Brandão; João Gonçalves Almeida; Paulo Fonseca; Joel Monteiro; Elisabeth Santos; Filipa Rosas; José Nogueira Ribeiro; Marco Oliveira; Helena Gonçalves; João Primo; Ricardo Fontes-Carvalho Journal: Heart Rhythm O2 Date: 2021-12-17
Authors: Bogdan Beca; John L Sapp; Martin J Gardner; Christopher Gray; Amir AbdelWahab; Ciorsti MacIntyre; Steve Doucette; Ratika Parkash Journal: CJC Open Date: 2019-03-06