Lead- and device-related complications in the Antiarrhythmics Versus Implantable Defibrillators Trial

Kron, Jack; Herre, John M.; Renfroe, Ellen Graham; Rizo-Patrón, Carlos; Raitt, Merritt H.; Halperin, Blair D.; Gold, Michael R.; Goldner, Bruce; Wathen, Mark S.; Wilkoff, Bruce L.; Olarte, Anna; Yao, Qing

doi:10.1067/mhj.2001.111261

Cited by 141 publications

(94 citation statements)

References 19 publications

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“…[3][4][5][7][8][9][10][11][12][13][14][15][16][17] The present study is concordant with previously reported complication rates. However, these trials have neither identified predictors of risk of ICD implantation nor been used to produce simple risk scores that can be used to prospectively help guide patient care.…”

Section: Prior Studiessupporting

confidence: 93%

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Implantable Cardioverter-Defibrillator Registry Risk Score Models for Acute Procedural Complications or Death After Implantable Cardioverter-Defibrillator Implantation

2011

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Background-Patients undergoing implantable cardioverter-defibrillator (ICD) implantation are at risk of postprocedural complications. However, we do not have a risk stratification schema to identify patients at high and low risk of adverse events. Methods and Results-We analyzed data from 268 701 ICD implants submitted to the ICD Registry and developed logistic regression models to identify variables most strongly associated with the risk of acute complications and/or in-hospital death. Overall, 3.2% of the population experienced an adverse event. A simple risk score consisting of 10 readily available variables successfully identified patients at high and low risk of complications. The variables included in the score and assigned points included: age Ն70 years (1 point), female (2 points), New York Heart Association class III (1 point) or IV (3 points), atrial fibrillation (1 point), prior valve surgery (3 points), chronic lung disease (2 points), blood urea nitrogen Ͼ30 (2 points), reimplantation for reasons other than battery change (6 points), ICD type dual chamber (2 points) or biventricular (4 points), and nonelective ICD implant (3 points). The risk of any in-hospital complication increased from 0.6% among patients with a score of Յ5 (8.4% of the population) to 8.4% among patients with Ն19 risk points (3.9% of the population). Conclusions-A simple risk score consisting of readily available clinical variables can identify high-and low-risk subsets of patients undergoing ICD implantation. This information can guide the physician in patient selection and determining the intensity of care required post procedure.

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Section: Prior Studiessupporting

confidence: 93%

“…6 Despite the fact that technological advances have reduced the complexity of device implantation, the procedure carries a significant risk of complications. [3][4][5][7][8][9][10][11][12][13][14][15][16][17] Procedural complications are associated with considerable patient morbidity and mortality, increased hospital length of stay, and increased costs. 17 …”

mentioning

confidence: 99%

Implantable Cardioverter-Defibrillator Registry Risk Score Models for Acute Procedural Complications or Death After Implantable Cardioverter-Defibrillator Implantation

2011

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“…Lead-related problems can occur at any time during long-term follow-up (Kron J et al, 2001;Yap SC et al, 2007) with the vast majority of lead dislodgments occurring within the first postoperative months. With increasing age of the transvenous lead systems, a growing number of lead fractures and insulation defects have to be expected (Mewis C., 1997; Kron J., 2003).…”

Section: Pulmonary Cardiovascular and Mechanical Complications Of Immentioning

confidence: 99%

“…With increasing age of the transvenous lead systems, a growing number of lead fractures and insulation defects have to be expected (Mewis C., 1997; Kron J., 2003). Necessity for operative revision is reported for 6% within 1 year of initial implant and up to 15% during 4 years (Kron J et al, 2001). A relation between the incidence of lead-related complications and the number of leads used in ICD systems has been reported (Takahashi T et al,2002).…”

Section: Pulmonary Cardiovascular and Mechanical Complications Of Immentioning

confidence: 99%

Pulmonary, Cardiovascular and Mechanical Complications of Implantable Cardioverter Defibrillators (ICDs)

Hardavella¹,

Dionellis²,

Koulouris³

2011

Cardiac Defibrillation - Mechanisms, Challenges and Implications

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“…The majority of these complications are lead-related and usually occur within three months after implantation. 6,[12][13][14][15] Causes of ICD lead failure are an insulation defect or conductor disruption, which can both affect the high-voltage or the pace-sense circuit of the system. Potential complications of ICD lead failure include oversensing of noise, undersensing of ventricular arrhythmias, inappropriate therapy, and lethal proarrhythmia.…”

Section: Remote Monitoring Systemsmentioning

confidence: 99%

Remote monitoring in implantable defibrillator therapy

Theuns¹,

Jordaens²

2008

NHJL

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The major device manufacturers have introduced systems for remote patient monitoring. These remote monitoring systems promise more efficient patient management, especially in today's clinical setting with the growing number of defibrillator implantations. The aim of this article is to present the role of remote patient monitoring in implantable cardioverter-defibrillator follow-up, its potential benefits and its barriers to widespread diffusion. (Neth Heart J 2008;16:53-6.)

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Lead- and device-related complications in the Antiarrhythmics Versus Implantable Defibrillators Trial

Cited by 141 publications

References 19 publications

Implantable Cardioverter-Defibrillator Registry Risk Score Models for Acute Procedural Complications or Death After Implantable Cardioverter-Defibrillator Implantation

Implantable Cardioverter-Defibrillator Registry Risk Score Models for Acute Procedural Complications or Death After Implantable Cardioverter-Defibrillator Implantation

Pulmonary, Cardiovascular and Mechanical Complications of Implantable Cardioverter Defibrillators (ICDs)

Remote monitoring in implantable defibrillator therapy

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