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56 ‘Pacing yourself’ – review of device-related complications performed by a single operator and the influence of device type and operator experience
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56 ‘Pacing yourself’ – review of device-related complications performed by a single operator and the influence of device type and operator experience
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Journal Article
56 ‘Pacing yourself’ – review of device-related complications performed by a single operator and the influence of device type and operator experience
2025
Overview
IntroductionCardiac devices play a crucial role in managing multiple cardiac conditions. This review evaluates the spectrum of Cardiac Implantable Electronic Device procedures performed by a single operator over 11 years, focusing on post-operative complications and their trends over time.MethodsRetrospective analysis was performed on 1,597 patients who underwent a device-related procedure between October 2013 and November 2024 by a single operator. Data assessed was collected prospectively.Results1,597 patients (1,098 male, 499 female) were included. Mean age was 73.2. Mean BMI was 26. 517 had a history of heart failure. 961 procedures were elective, 548 urgent, and 88 emergency. The cephalic vein alone was used 325 times as an access route, subclavian/axillary veins alone 696 times, and both cephalic and subclavian/axillary veins 156 times. Insertion of a new device occurred in 985 cases; the remainder were revisions (208), box changes (339), explants (27), and other procedures (25). 484 dual-chamber pacemakers were implanted, making it the most common device, with cardiac resynchronisation therapy-defibrillator (CRT-D) second most common (267) and single-chamber pacemakers (245) third (table 1). The most common complications within 1 year included atrial-lead displacement (17), wound infections requiring re-operation (15), and right-ventricular-lead displacement (12) (figure 1). Table 2 outlines the specific complication rate of each device (those not included did not account for any of the 94 complications). Emergency procedures had the highest setting-specific complication rate (8%), compared with 6% of urgent cases and 5.5% of elective procedures. Figure 2 demonstrates the procedure complication rate per year, with years 9 and 11 having the lowest rate (3%) and year 3 the highest (8%).Conclusion1,597 device-related procedures were performed by a single operator over 11 years. CRT-D and DDD-ICD had the highest complication rate, 9% and 8.5% respectively. Overall, complication rates declined with increasing operator experience.Abstract 56 Table 1Type of device[Image Omitted. See PDF.]Abstract 56 Table 2Device-specific complication rate[Image Omitted. See PDF.]Abstract 56 Figure 1Complications[Image Omitted. See PDF.]Abstract 56 Figure 2Combination rate by year[Image Omitted. See PDF.]
Publisher
BMJ Publishing Group LTD
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