Cardiac perforation from implantable cardioverter-defibrillator lead placement: Insights from the National Cardiovascular Data Registry

Jonathan C. Hsu, Paul D. Varosy, Haikun Bao, Thomas Dewland, Jeptha P. Curtis, Gregory M. Marcus

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Background-Cardiac perforation is a feared complication of implantable cardioverter-defibrillator (ICD) lead implantation because of the potential for significant morbidity and mortality. Predictors of perforation and the severity of associated adverse events have not been well studied. We sought to identify predictors of cardiac perforation from ICD lead implantation and subsequent outcomes. Methods and Results-We studied 440 251 first-time ICD recipients in the ICD Registry implanted between January 2006 and September 2011. Using hierarchical multivariable logistic regression adjusting for patient, implanting physician, and hospital characteristics, we examined the predictors of perforation and the association of perforation with other major complications, length of stay, and in-hospital mortality. Cardiac perforation occurred in 625 patients (0.14%). After multivariable adjustment, older age, female sex, left bundle branch block, worsened heart failure class, higher left ventricular ejection fraction, and non-single-chamber ICD implant were associated with a greater odds of perforation. Conversely, atrial fibrillation, diabetes mellitus, previous cardiac bypass surgery, and higher implanter procedural volume were associated with a lower odds of perforation (all P3 days (odds ratio, 16.3; 95% confidence interval, 13.7-19.4; P

Original languageEnglish (US)
Pages (from-to)582-590
Number of pages9
JournalCirculation: Cardiovascular Quality and Outcomes
Volume6
Issue number5
DOIs
StatePublished - Sep 2013
Externally publishedYes

Fingerprint

Implantable Defibrillators
Registries
Bundle-Branch Block
Hospital Mortality
Stroke Volume
Atrial Fibrillation
Thoracic Surgery
Length of Stay
Diabetes Mellitus
Heart Failure
Logistic Models
Odds Ratio
Lead
Confidence Intervals
Morbidity
Physicians
Mortality

Keywords

  • Adverse events complication
  • Cardiac perforation
  • Complication
  • Defibrillators, implantable
  • Mortality
  • National registry

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Cardiac perforation from implantable cardioverter-defibrillator lead placement : Insights from the National Cardiovascular Data Registry. / Hsu, Jonathan C.; Varosy, Paul D.; Bao, Haikun; Dewland, Thomas; Curtis, Jeptha P.; Marcus, Gregory M.

In: Circulation: Cardiovascular Quality and Outcomes, Vol. 6, No. 5, 09.2013, p. 582-590.

Research output: Contribution to journalArticle

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