Long-Term Complications Related to Biventricular Defibrillator Implantation

• DOI: 10.1161/circulationaha.110.015024
• Publication Date: 2011-05-17T05:12:11Z
• Authors: Maurizio Landolina; Maurizio Gasparini; Maurizio Lunati; Saverio Iacopino; Giuseppe Boriani; Carlo Bonanno; Antonello Vado; Alessandro Proclemer; Alessandro Capucci; Chantal Zucchiatti; Sergio Valsecchi; Renato P. Ricci; Massimo Santini
• Keywords: Heart Failure; Male; Reoperation; Time Factors; Databases, Factual; Middle Aged; Defibrillators, Implantable; 3. Good health; Cardiac Resynchronization Therapy; Survival Rate; 03 medical and health sciences; Postoperative Complications; Treatment Outcome; 0302 clinical medicine; Italy; Humans; Female; CARDIAC RESYNCHRONIZATION THERAPY; POSTOPERATIVE COMPLICATIONS; HEART FAILURE; Aged; Follow-Up Studies

Background— Long-term data on device-related untoward events in patients receiving defibrillators for resynchronization therapy (CRT-D) are lacking. We quantified the frequency of repeat invasive procedures and nature long-term complications current clinical practice examined possible predictors their association with patient outcome. Methods Results— analyzed from 3253 who underwent de novo successful implantation CRT-D were followed up a median 18 months (25th to 75th percentiles: 9 30) 117 Italian centers. Device-related reported 416 patients, and, specifically, surgical interventions system revision described 390 patients. Four years after procedure, 50% battery depletion 14% unanticipated events. For comparison, at 4 occurred 10% 13% received single- dual-chamber study centers, as 4% 9%, respectively. In CRT-D, infections rate 1.0%/y, risk increased device replacement (hazard ratio, 2.04; 95% confidence interval, 1.01 4.09; P =0.045). Left ventricular lead dislodgements 2.3%/y predicted by longer fluoroscopy time higher pacing threshold implantation. not associated worse outcome; indeed, death was similar without 0.90; 0.56 1.47; =0.682). Conclusions— more frequent than or defibrillators, frequently managed intervention revision. However, outcome is these Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT01007474.