Complications in recipients of cardioverter-defibrillator or cardiac resynchronization therapy: Insights from Silesian Center Defibrillator registry

Cardiol J. 2017;24(5):515-522. doi: 10.5603/CJ.a2016.0092. Epub 2016 Oct 13.

Abstract

Background: Current real-life information from all-comers registries from middle and east Europe about the incidence and type of complications during long-term follow-up of patients with cardioverters-defibrillators (ICD) and cardiac resynchronization devices-defibrillators (CRT-D) is still insufficient. The aim of the study was to assess the incidence and determinants of short- and long-term complications related to implantable ICD and CRT-D.

Methods: We studied 1,105 recipients hospitalized in our center in 2009-2013, followed for a mean of 2.4 years (total of 2,652 patient-years). The independent association between ICD and CRT-D recipients' and implantation-procedures' characteristics with the incidence of complications was analyzed using multivariable Cox regression analysis.

Results: In 2-month post-procedural period, 124 (11.2%) patients developed complications. Independent predictors of short-term complications (within 2 months) were: atrial fibrillation, dual chamber ICD implantation, and use of antiplatelet therapy or coumarin. Twenty-seven (2.44%) patients experienced complications, mostly lead-related (n = 21). Independent predictors of long-term complications (2-12 months after implantation) were atrial fibrillation and dual chamber ICD implantation.

Conclusions: Despite significant technological progress and operators' experience, the occurrence of complications in ICD and CRT-D recipients is still substantial. Majority of complications are recorded in the early post-implantation phase. Analysis of independent predictors of complications seem to be essential in helping to reduce adverse events in the future and strongly supports the need for routine follow-up.

Keywords: cardiac electronic implantable devices; cardiac resynchronization therapy; cardioverter-defibrillator; complications; registry.

MeSH terms

  • Aged
  • Cardiac Resynchronization Therapy Devices*
  • Cardiac Resynchronization Therapy* / adverse effects
  • Cardiac Resynchronization Therapy* / mortality
  • Comorbidity
  • Defibrillators, Implantable*
  • Disease-Free Survival
  • Electric Countershock / adverse effects
  • Electric Countershock / instrumentation*
  • Electric Countershock / mortality
  • Female
  • Heart Failure / diagnosis
  • Heart Failure / mortality
  • Heart Failure / physiopathology
  • Heart Failure / therapy*
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Poland / epidemiology
  • Proportional Hazards Models
  • Prosthesis Design
  • Prosthesis Failure
  • Registries
  • Retrospective Studies
  • Risk Factors
  • Stroke Volume
  • Time Factors
  • Treatment Outcome
  • Ventricular Function, Left