Kowlgi Gurukripa N, Vaidya Vaibhav, Dai Ming-Yan, Futela Pragyat, Mishra Rahul, Hodge David O, Deshmukh Abhishek J, Mulpuru Siva K, Friedman Paul A, Cha Yong-Mei
Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota.
Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, Florida.
Heart Rhythm O2. 2024 Feb 14;5(3):158-167. doi: 10.1016/j.hroo.2024.02.001. eCollection 2024 Mar.
Cardiac implantable electronic devices (CIEDs), such as permanent pacemakers, implantable cardioverter-defibrillators, and cardiac resynchronization therapy devices, alleviate morbidity and mortality in various diseases. There is a paucity of real-world data on CIED complications and trends.
We sought to describe trends in noninfectious CIED complications over the past 3 decades in Olmsted County.
The Rochester Epidemiology Project is a medical records linkage system comprising records of over 500,000 residents of Olmsted County from 1966 to present. CIED implantations between 1988 and 2018 were determined. Trends in noninfectious complications within 30 days of implantation were analyzed.
A total of 157 (6.2%) of 2536 patients who received CIED experienced device complications. A total of 2.7% of the implants had major complications requiring intervention. Lead dislodgement was the most common (2.8%), followed by hematoma (1.7%). Complications went up from 1988 to 2005, and then showed a downtrend until 2018, driven by a decline in hematomas in the last decade ( .01). Those with complications were more likely to have prosthetic valves. Obesity appeared to have a protective effect in a multivariate regression model. The mean Charlson comorbidity index has trended up over the 30 years.
Our study describes a real-world trend of CIED complications over 3 decades. Lead dislodgements and hematomas were the most common complications. Complications have declined over the last decade due to safer practices and a better understanding of anticoagulant management.
心脏植入式电子设备（CIED），如永久性起搏器、植入式心脏复律除颤器和心脏再同步治疗设备，可降低各种疾病的发病率和死亡率。关于CIED并发症及趋势的真实世界数据较少。
我们试图描述过去30年奥尔姆斯特德县非感染性CIED并发症的趋势。
罗切斯特流行病学项目是一个医疗记录链接系统，包含1966年至今奥尔姆斯特德县50多万居民的记录。确定1988年至2018年期间的CIED植入情况。分析植入后30天内非感染性并发症的趋势。
2536例接受CIED的患者中，共有157例（6.2%）出现设备并发症。共有2.7%的植入物出现需要干预的严重并发症。导线脱位最常见（2.8%），其次是血肿（1.7%）。并发症从1988年到2005年上升，然后呈下降趋势直至2018年，这是由过去十年血肿减少所驱动的（P<0.01）。出现并发症的患者更可能有人工瓣膜。在多变量回归模型中，肥胖似乎有保护作用。在这30年中，平均查尔森合并症指数呈上升趋势。
我们的研究描述了30年中CIED并发症的真实世界趋势。导线脱位和血肿是最常见的并发症。由于操作更安全以及对抗凝管理有了更好的理解，并发症在过去十年中有所下降。
