Device complications in adult congenital heart disease

Robert M. Hayward, Thomas Dewland, Brian Moyers, Eric Vittinghoff, Ronn E. Tanel, Gregory M. Marcus, Zian H. Tseng

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background Pacemakers and implantable cardioverter-defibrillators (ICDs) are increasingly implanted in adults with congenital heart disease (CHD), but little is known about implant-related complications and mortality. Objective The purpose of this study was to compare pacemaker and ICD implantation complication rates between adults with and those without CHD using a comprehensive, statewide database. Methods We used the Healthcare Cost and Utilization Project database to identify initial transvenous pacemaker and ICD implantations and implant-related complications in California hospitals from January 1, 2005, to December 31, 2011. We calculated relative risks of implant-related complications by comparing those with and those without CHD using Poisson regression with robust standard errors, adjusting for age and medical comorbidities. Results We identified 105,852 patients undergoing pacemaker implantation, 1465 with noncomplex CHD and 66 with complex CHD. CHD was not associated with increased risk of pacemaker implant-related complications: adjusted risk ratio (aRR) 0.92, 95% confidence interval (CI) 0.74-1.14, P =.45. We identified 32,948 patients undergoing ICD implantation, 815 with noncomplex CHD and 87 with complex CHD. Patients with CHD had increased risk of ICD implant-related complications: aRR 1.36, 95% CI 1.05-1.76, P =.02. Patients with complex CHD had greater increased risk of ICD implant-related complications: aRR 2.14, 95% CI 1.16-3.95, P =.02. In patients receiving devices, CHD was associated with a trend toward lower 30-day in-hospital mortality after pacemaker (P =.07) and ICD (P =.19) implantation. Conclusion Among adult patients undergoing device implantation in California, CHD was associated with increased risk of ICD implant-related complications, but not pacemaker implant-related complications or higher 30-day in-hospital mortality.

Original languageEnglish (US)
Pages (from-to)338-344
Number of pages7
JournalHeart Rhythm
Volume12
Issue number2
DOIs
StatePublished - Feb 1 2015
Externally publishedYes

Fingerprint

Heart Diseases
Implantable Defibrillators
Equipment and Supplies
Odds Ratio
Confidence Intervals
Hospital Mortality
Databases
Health Care Costs
Comorbidity
Mortality

Keywords

  • Congenital heartdisease
  • Implantable cardioverter-defibrillator
  • Pacemaker

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)
  • Medicine(all)

Cite this

Hayward, R. M., Dewland, T., Moyers, B., Vittinghoff, E., Tanel, R. E., Marcus, G. M., & Tseng, Z. H. (2015). Device complications in adult congenital heart disease. Heart Rhythm, 12(2), 338-344. https://doi.org/10.1016/j.hrthm.2014.10.038

Device complications in adult congenital heart disease. / Hayward, Robert M.; Dewland, Thomas; Moyers, Brian; Vittinghoff, Eric; Tanel, Ronn E.; Marcus, Gregory M.; Tseng, Zian H.

In: Heart Rhythm, Vol. 12, No. 2, 01.02.2015, p. 338-344.

Research output: Contribution to journalArticle

Hayward, RM, Dewland, T, Moyers, B, Vittinghoff, E, Tanel, RE, Marcus, GM & Tseng, ZH 2015, 'Device complications in adult congenital heart disease', Heart Rhythm, vol. 12, no. 2, pp. 338-344. https://doi.org/10.1016/j.hrthm.2014.10.038
Hayward RM, Dewland T, Moyers B, Vittinghoff E, Tanel RE, Marcus GM et al. Device complications in adult congenital heart disease. Heart Rhythm. 2015 Feb 1;12(2):338-344. https://doi.org/10.1016/j.hrthm.2014.10.038
Hayward, Robert M. ; Dewland, Thomas ; Moyers, Brian ; Vittinghoff, Eric ; Tanel, Ronn E. ; Marcus, Gregory M. ; Tseng, Zian H. / Device complications in adult congenital heart disease. In: Heart Rhythm. 2015 ; Vol. 12, No. 2. pp. 338-344.
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abstract = "Background Pacemakers and implantable cardioverter-defibrillators (ICDs) are increasingly implanted in adults with congenital heart disease (CHD), but little is known about implant-related complications and mortality. Objective The purpose of this study was to compare pacemaker and ICD implantation complication rates between adults with and those without CHD using a comprehensive, statewide database. Methods We used the Healthcare Cost and Utilization Project database to identify initial transvenous pacemaker and ICD implantations and implant-related complications in California hospitals from January 1, 2005, to December 31, 2011. We calculated relative risks of implant-related complications by comparing those with and those without CHD using Poisson regression with robust standard errors, adjusting for age and medical comorbidities. Results We identified 105,852 patients undergoing pacemaker implantation, 1465 with noncomplex CHD and 66 with complex CHD. CHD was not associated with increased risk of pacemaker implant-related complications: adjusted risk ratio (aRR) 0.92, 95{\%} confidence interval (CI) 0.74-1.14, P =.45. We identified 32,948 patients undergoing ICD implantation, 815 with noncomplex CHD and 87 with complex CHD. Patients with CHD had increased risk of ICD implant-related complications: aRR 1.36, 95{\%} CI 1.05-1.76, P =.02. Patients with complex CHD had greater increased risk of ICD implant-related complications: aRR 2.14, 95{\%} CI 1.16-3.95, P =.02. In patients receiving devices, CHD was associated with a trend toward lower 30-day in-hospital mortality after pacemaker (P =.07) and ICD (P =.19) implantation. Conclusion Among adult patients undergoing device implantation in California, CHD was associated with increased risk of ICD implant-related complications, but not pacemaker implant-related complications or higher 30-day in-hospital mortality.",
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AU - Hayward, Robert M.

AU - Dewland, Thomas

AU - Moyers, Brian

AU - Vittinghoff, Eric

AU - Tanel, Ronn E.

AU - Marcus, Gregory M.

AU - Tseng, Zian H.

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N2 - Background Pacemakers and implantable cardioverter-defibrillators (ICDs) are increasingly implanted in adults with congenital heart disease (CHD), but little is known about implant-related complications and mortality. Objective The purpose of this study was to compare pacemaker and ICD implantation complication rates between adults with and those without CHD using a comprehensive, statewide database. Methods We used the Healthcare Cost and Utilization Project database to identify initial transvenous pacemaker and ICD implantations and implant-related complications in California hospitals from January 1, 2005, to December 31, 2011. We calculated relative risks of implant-related complications by comparing those with and those without CHD using Poisson regression with robust standard errors, adjusting for age and medical comorbidities. Results We identified 105,852 patients undergoing pacemaker implantation, 1465 with noncomplex CHD and 66 with complex CHD. CHD was not associated with increased risk of pacemaker implant-related complications: adjusted risk ratio (aRR) 0.92, 95% confidence interval (CI) 0.74-1.14, P =.45. We identified 32,948 patients undergoing ICD implantation, 815 with noncomplex CHD and 87 with complex CHD. Patients with CHD had increased risk of ICD implant-related complications: aRR 1.36, 95% CI 1.05-1.76, P =.02. Patients with complex CHD had greater increased risk of ICD implant-related complications: aRR 2.14, 95% CI 1.16-3.95, P =.02. In patients receiving devices, CHD was associated with a trend toward lower 30-day in-hospital mortality after pacemaker (P =.07) and ICD (P =.19) implantation. Conclusion Among adult patients undergoing device implantation in California, CHD was associated with increased risk of ICD implant-related complications, but not pacemaker implant-related complications or higher 30-day in-hospital mortality.

AB - Background Pacemakers and implantable cardioverter-defibrillators (ICDs) are increasingly implanted in adults with congenital heart disease (CHD), but little is known about implant-related complications and mortality. Objective The purpose of this study was to compare pacemaker and ICD implantation complication rates between adults with and those without CHD using a comprehensive, statewide database. Methods We used the Healthcare Cost and Utilization Project database to identify initial transvenous pacemaker and ICD implantations and implant-related complications in California hospitals from January 1, 2005, to December 31, 2011. We calculated relative risks of implant-related complications by comparing those with and those without CHD using Poisson regression with robust standard errors, adjusting for age and medical comorbidities. Results We identified 105,852 patients undergoing pacemaker implantation, 1465 with noncomplex CHD and 66 with complex CHD. CHD was not associated with increased risk of pacemaker implant-related complications: adjusted risk ratio (aRR) 0.92, 95% confidence interval (CI) 0.74-1.14, P =.45. We identified 32,948 patients undergoing ICD implantation, 815 with noncomplex CHD and 87 with complex CHD. Patients with CHD had increased risk of ICD implant-related complications: aRR 1.36, 95% CI 1.05-1.76, P =.02. Patients with complex CHD had greater increased risk of ICD implant-related complications: aRR 2.14, 95% CI 1.16-3.95, P =.02. In patients receiving devices, CHD was associated with a trend toward lower 30-day in-hospital mortality after pacemaker (P =.07) and ICD (P =.19) implantation. Conclusion Among adult patients undergoing device implantation in California, CHD was associated with increased risk of ICD implant-related complications, but not pacemaker implant-related complications or higher 30-day in-hospital mortality.

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KW - Implantable cardioverter-defibrillator

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