Outcome of advisory implantable cardioverter-defibrillator replacement: One-year follow-up

被引：50

作者：

Gould, Paul A. ^{[1
]}

Gula, Lorne J. ^{[1
]}

Champagne, Jean ^{[2
]}

Healyey, Jeffrey S. ^{[3
]}

Cameron, Doug ^{[4
]}

Simpson, Christophers ^{[5
]}

Thibault, Bernard ^{[6
]}

Pinter, Arnold ^{[7
]}

Tung, Stanley ^{[8
]}

Sterns, Laurence ^{[9
]}

Birnie, David ^{[10
]}

Exner, Derek ^{[11
]}

Parkash, Ratika ^{[12
]}

Skanes, Allan C. ^{[1
]}

Yee, Raymond ^{[1
]}

Klein, George J. ^{[1
]}

Krahn, Andrew D. ^{[1
]}

机构：

[1] Univ Western Ontario, London, ON, Canada

[2] Laval Hosp, Quebec Heart Inst, Quebec City, PQ, Canada

[3] Hamilton Hlth Sci Ctr, Hamilton, ON, Canada

[4] Univ Hlth Network, Toronto, ON, Canada

[5] Queens Univ, Kingston, ON, Canada

[6] Montreal Heart Inst, Montreal, PQ H1T 1C8, Canada

[7] St Michaels Hosp, Toronto, ON M5B 1W8, Canada

[8] St Pauls Hosp, Vancouver, BC V6Z 1Y6, Canada

[9] Vancouver Isl Hlth Author, Victoria, BC, Canada

[10] Ottawa Heart Inst, Ottawa, ON, Canada

[11] Foothills Prov Gen Hosp, Calgary, AB T2N 2T9, Canada

[12] QEII Hlth Sci Ctr, Halifax, NS, Canada

来源：

HEART RHYTHM | 2008年 / 5卷 / 12期

关键词：

Implantable cardioverter defibrillator; Advisory; Infection; Complications; Risk factors;

D O I：

10.1016/j.hrthm.2008.09.020

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BACKGROUND Implantable cardioverter defibrillator (ICD) generator advisories present management dilemmas for physicians regarding competing risks of ICD failure and replacement-related complications. There is currently a paucity of tong-term data concerning the complications associated with advisory ICD replacement. OBJECTIVE In a large multicenter advisory ICD generator replacement cohort followed for 12 months, we aimed to assess replacement-related complications by performing a case-control determination of complication risk factors to identify characteristics that could assist with advisory ICD replacement decision making. METHODS Twelve large ICD implanting centers reviewed the 1-year follow-up outcome of advisory ICDs replaced between October 2004 and October 2005. The complication cohort was characterized and compared in a nested case-control analysis with age- and gender-matched controls without complications from the same replacement population. RESULTS At the 12 participating institutions, 451 of 2635 advisory ICD devices were replaced (17.1%). Over 355 +/- 204 days of follow-up, there were 41 (9.1%) complications; 27 (5.9%) required reoperation and included two deaths. There were 14 minor complications (3.1%). Multivariate analysis demonstrated that the number of previous pocket procedures was associated with an increase in complications and that combined consultant and fellow operators was associated with a decrease in complications compared with a single operator alone. CONCLUSIONS Complications from advisory ICD generator replacement are frequent and include infection and, rarely, death. The risk of replacement is increased in patients with multiple previous pocket procedures.

引用

页码：1675 / 1681

页数：7

共 23 条

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