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Cardiac device implantations in obese patients: Success rates and complications
Philipp Attanasio1, Philipp Lacour1, Andrea Ernert2
1Department of Cardiology, Campus Virchow-Klinikum, Charité University Hospital Berlin, Germany.
Insights
Cardiac implantable electronic device (CIED) implantation is safe and effective in obese patients. Despite similar success rates, obese patients experienced fewer complications but higher radiation exposure during CIED procedures.
Area of Science:
- Cardiology
- Medical Devices
- Obesity Medicine
Background:
- Obesity is linked to increased risks and poorer outcomes in cardiac interventions.
- This study investigated the safety and efficacy of cardiac implantable electronic device (CIED) implantation in obese individuals.
Purpose of the Study:
- To compare success and complication rates of CIED implantation between obese and nonobese patients.
- To evaluate procedural duration, fluoroscopy time, and radiation dose in obese versus nonobese patients.
Main Methods:
- A retrospective analysis of 965 patients undergoing CIED implantation (2011-2015).
- Patients were stratified into obese (BMI ≥ 30 kg/m²) and nonobese groups.
- Comparison of procedural success, complication rates, and radiation exposure between groups.
Main Results:
- No significant difference in procedural success rates between obese (97.2%) and nonobese (97.1%) patients.
- Major complication rates were lower in the obese group (4.4%) compared to the nonobese group (8.7%).
- Obese patients had a significantly higher total dose-area product (radiation exposure) despite similar procedural and fluoroscopy durations.
Conclusions:
- CIED implantation is safe and effective in patients with a BMI > 30 kg/m².
- While complication rates are lower in obese patients, increased radiation exposure necessitates strategies to minimize dose.
Background:
Obesity is associated with increased complications and potentially worse outcomes for various cardiac interventions. This study analyzed the success rate and complication rates associated with implantation of cardiac implantable electronic devices (CIEDs) in obese patients.
Hypothesis:
Success rates are lower and complication rates higher in obese patients.
Methods:
Consecutive patients undergoing CIED implantation between 2011 and 2015 in our hospital were included. Patients were categorized into obese and nonobese groups according to body mass index (BMI); cutoff was 30 kg/m2 . Patient characteristics, complication rates, procedural duration, and fluoroscopy data were compared between the 2 groups.
Results:
A total of 965 patients (mean age, 69.0 ± 12.9 years; 67% male) were included. Of these, 249 (25.8%) patients were classified obese and 716 (74.2%) nonobese. Mean BMI was 34.7 ± 4.7 kg/m2 vs 25.1 ± 3.0 kg/m2 , respectively. There was no difference in procedural success rates between the 2 groups (97.2% vs 97.1%, respectively). Major complications were significantly lower in the obese group compared with the nonobese group (11 [4.4%] vs 62 [8.7%]; P < 0.05). Procedural duration and fluoroscopy duration were not different between the 2 groups, but the total dose-area product was significantly higher in obese patients vs nonobese patients (4012 ± 5416 cGcm2 vs 2692 ± 5277 cGcm2 ; P < 0.005).
Conclusions:
CIED implantation can be safely and effectively achieved in patients with BMI >30 kg/m2 . However, total radiation dose was significantly higher in the obese group, emphasizing that efforts should be made to reduce radiation exposure in these patients.
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