Risk factors for lead complications in cardiac pacing: A population-based cohort study of 28,860 Danish patients

Kirkfeldt, RE; Johansen, JB; Nohr, EA; Moller, M; Arnsbo, P; Nielsen, JC

Risk factors for lead complications in cardiac pacing: A population-based cohort study of 28,860 Danish patients

Kirkfeldt, RE Johansen, JB Nohr, EA Moller, M Arnsbo, P Nielsen, JC

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Publication Type:: Journal Article
Citation:: Heart Rhythm, 2011, 8 (10), pp. 1622 - 1628
Issue Date:: 2011-10-01

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Field	Value	Language
dc.contributor.author	Kirkfeldt, RE	en_US
dc.contributor.author	Johansen, JB	en_US
dc.contributor.author	Nohr, EA	en_US
dc.contributor.author	Moller, M	en_US
dc.contributor.author	Arnsbo, P	en_US
dc.contributor.author	Nielsen, JC	en_US
dc.date.available	2011-04-06	en_US
dc.date.issued	2011-10-01	en_US
dc.identifier.citation	Heart Rhythm, 2011, 8 (10), pp. 1622 - 1628	en_US
dc.identifier.issn	1547-5271	en_US
dc.identifier.uri	http://hdl.handle.net/10453/117922
dc.description.abstract	Background: Lead complications are the main reason for reoperation after implantation of pacemakers (PM) or cardiac resynchronization therapy (CRT-P) devices. Objective: This study sought to describe the incidence of lead complications causing reoperation after device implantation and to identify risk factors for lead complications. Methods: A nationwide, population-based, historic cohort study was performed based on data from the Danish Pacemaker Register, which includes all Danish patients who received their first PM or CRT-P device from 1997 to 2008. Follow-up occurred 3 months after implantation. Results: The study population consisted of 28,860 patients. The incidence of any lead complication was 3.6%, encompassing right atrial (RA; 2.3%), right ventricular (2.2%), and left ventricular (4.3%) lead complications. The lead complication risk declined during the first part of the study period and remained stable after 2002. Multivariate analysis identified the following significant risk factors: chronic heart failure as indication (adjusted odds ratio (aOR) 3.0; 95% confidence interval [CI] 2.1 to 4.3), implantation in a nonuniversity center (aOR 1.4; 95% CI 1.2 to 1.6), inexperienced operator with <25 implantations (aOR 1.6; 95% CI 1.3 to 2.0), single-lead RA device (aOR 1.4; 95% CI 1.1 to 1.8), dual-chamber pacing device (aOR 1.6; 95% CI 1.4 to 1.9), CRT-P device (aOR 3.3; 95% CI 2.4 to 4.4) and passive-fixation RA lead (aOR 2.2; 95% CI 1.7 to 2.9). Conclusion: Lead complications causing reoperation remain a clinically important problem in device therapy. Mainly procedure-related factors were identified as independent risk factors for lead complications. © 2011 Heart Rhythm Society.	en_US
dc.relation.ispartof	Heart Rhythm	en_US
dc.relation.isbasedon	10.1016/j.hrthm.2011.04.014	en_US
dc.subject.classification	Cardiovascular System & Hematology	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Cardiac Pacing, Artificial	en_US
dc.subject.mesh	Reoperation	en_US
dc.subject.mesh	Registries	en_US
dc.subject.mesh	Incidence	en_US
dc.subject.mesh	Logistic Models	en_US
dc.subject.mesh	Risk Factors	en_US
dc.subject.mesh	Chi-Square Distribution	en_US
dc.subject.mesh	Cohort Studies	en_US
dc.subject.mesh	Electrodes, Implanted	en_US
dc.subject.mesh	Denmark	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.title	Risk factors for lead complications in cardiac pacing: A population-based cohort study of 28,860 Danish patients	en_US
dc.type	Journal Article
utslib.citation.volume	10	en_US
utslib.citation.volume	8	en_US
utslib.for	0903 Biomedical Engineering	en_US
utslib.for	1102 Cardiorespiratory Medicine and Haematology	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
utslib.copyright.status	closed_access
pubs.issue	10	en_US
pubs.publication-status	Published	en_US
pubs.volume	8	en_US

Abstract:

Background: Lead complications are the main reason for reoperation after implantation of pacemakers (PM) or cardiac resynchronization therapy (CRT-P) devices. Objective: This study sought to describe the incidence of lead complications causing reoperation after device implantation and to identify risk factors for lead complications. Methods: A nationwide, population-based, historic cohort study was performed based on data from the Danish Pacemaker Register, which includes all Danish patients who received their first PM or CRT-P device from 1997 to 2008. Follow-up occurred 3 months after implantation. Results: The study population consisted of 28,860 patients. The incidence of any lead complication was 3.6%, encompassing right atrial (RA; 2.3%), right ventricular (2.2%), and left ventricular (4.3%) lead complications. The lead complication risk declined during the first part of the study period and remained stable after 2002. Multivariate analysis identified the following significant risk factors: chronic heart failure as indication (adjusted odds ratio (aOR) 3.0; 95% confidence interval [CI] 2.1 to 4.3), implantation in a nonuniversity center (aOR 1.4; 95% CI 1.2 to 1.6), inexperienced operator with <25 implantations (aOR 1.6; 95% CI 1.3 to 2.0), single-lead RA device (aOR 1.4; 95% CI 1.1 to 1.8), dual-chamber pacing device (aOR 1.6; 95% CI 1.4 to 1.9), CRT-P device (aOR 3.3; 95% CI 2.4 to 4.4) and passive-fixation RA lead (aOR 2.2; 95% CI 1.7 to 2.9). Conclusion: Lead complications causing reoperation remain a clinically important problem in device therapy. Mainly procedure-related factors were identified as independent risk factors for lead complications. © 2011 Heart Rhythm Society.

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http://hdl.handle.net/10453/117922