Attanasio Philipp, Lacour Philipp, Ernert Andrea, Pieske Burkert, Haverkamp Wilhelm, Blaschke Florian, Dalle Vedove Francesco, Huemer Martin
Department of Cardiology, Campus Virchow-Klinikum, Charité University Hospital Berlin, Germany.
Department of Biometrics and Clinical Epidemiology, Campus Virchow-Klinikum, Charité University Hospital Berlin, Germany.
Clin Cardiol. 2017 Apr;40(4):230-234. doi: 10.1002/clc.22650. Epub 2017 Mar 23.
Obesity is associated with increased complications and potentially worse outcomes for various cardiac interventions. This study analyzed the success rate and complication rates associated with implantation of cardiac implantable electronic devices (CIEDs) in obese patients.
Success rates are lower and complication rates higher in obese patients.
Consecutive patients undergoing CIED implantation between 2011 and 2015 in our hospital were included. Patients were categorized into obese and nonobese groups according to body mass index (BMI); cutoff was 30 kg/m . Patient characteristics, complication rates, procedural duration, and fluoroscopy data were compared between the 2 groups.
A total of 965 patients (mean age, 69.0 ± 12.9 years; 67% male) were included. Of these, 249 (25.8%) patients were classified obese and 716 (74.2%) nonobese. Mean BMI was 34.7 ± 4.7 kg/m vs 25.1 ± 3.0 kg/m , respectively. There was no difference in procedural success rates between the 2 groups (97.2% vs 97.1%, respectively). Major complications were significantly lower in the obese group compared with the nonobese group (11 [4.4%] vs 62 [8.7%]; P < 0.05). Procedural duration and fluoroscopy duration were not different between the 2 groups, but the total dose-area product was significantly higher in obese patients vs nonobese patients (4012 ± 5416 cGcm vs 2692 ± 5277 cGcm ; P < 0.005).
CIED implantation can be safely and effectively achieved in patients with BMI >30 kg/m . However, total radiation dose was significantly higher in the obese group, emphasizing that efforts should be made to reduce radiation exposure in these patients.
肥胖与各种心脏介入治疗的并发症增加以及潜在的更差预后相关。本研究分析了肥胖患者植入心脏植入式电子设备（CIED）的成功率和并发症发生率。
肥胖患者的成功率较低，并发症发生率较高。
纳入2011年至2015年在我院连续接受CIED植入的患者。根据体重指数（BMI）将患者分为肥胖组和非肥胖组；临界值为30kg/m²。比较两组患者的特征、并发症发生率、手术持续时间和透视数据。
共纳入965例患者（平均年龄69.0±12.9岁；67%为男性）。其中，249例（25.8%）患者被分类为肥胖，716例（74.2%）为非肥胖。平均BMI分别为34.7±4.7kg/m²和25.1±3.0kg/m²。两组手术成功率无差异（分别为97.2%和97.1%）。肥胖组的主要并发症明显低于非肥胖组（11例[4.4%]对62例[8.7%]；P<0.05）。两组手术持续时间和透视持续时间无差异，但肥胖患者的总剂量面积乘积显著高于非肥胖患者（4012±5416cGcm²对2692±5277cGcm²；P<0.005）。
BMI>30kg/m²的患者可以安全有效地进行CIED植入。然而，肥胖组的总辐射剂量明显更高，强调应努力减少这些患者的辐射暴露。
