Related Experiment Video
Updated: Mar 1, 2026
Implantation of the Syncardia Total Artificial Heart
Published on: July 18, 2014
Cardiac implantable electronic device hematomas: Risk factors and effect of prophylactic pressure bandaging
Youlin Koh1, Nicholas E Bingham1, Natalie Law2
1Department of Cardiology, The Alfred Hospital, Prahran, Victoria, Australia.
Insights
Cardiac implantable electronic device hematomas are linked to adverse outcomes. Heparin, dual antiplatelets, and chronic kidney disease increase risk, while higher BMI may decrease it. Prophylactic pressure bandaging showed no significant effect.
Area of Science:
- Cardiology
- Medical Devices
- Clinical Outcomes
Background:
- Cardiac implantable electronic device (CIED) hematomas are a significant complication with adverse outcomes.
- Understanding incidence and risk factors for CIED hematoma is crucial for patient safety.
Purpose of the Study:
- To examine the incidence and risk factors for hematoma formation after CIED implantation.
- To explore the preventative effect of prophylactic pressure bandaging (PPB) on CIED hematoma.
Main Methods:
- A retrospective analysis of 1,091 CIED implantations between October 2011 and December 2014.
- Multivariate logistic regression was used to identify factors associated with hematoma incidence and clinically significant hematomas (CSH).
Main Results:
- 61 hematomas (5.6%) occurred, with 12 (1.1%) classified as CSH.
- Risk factors for any hematoma included chronic kidney disease (CKD) and dual antiplatelet therapy (aspirin + clopidogrel).
- Higher Body Mass Index (BMI) was associated with decreased hematoma risk, while heparin and dual antiplatelets strongly predicted CSH.
Conclusions:
- Heparin and dual antiplatelet use are significant predictors of CIED hematoma.
- Chronic kidney disease is a moderate predictor, and elevated BMI may be protective.
- Prophylactic pressure bandaging demonstrated no significant impact on hematoma development.
Background:
Cardiac implantable electronic device (CIED) hematomas are associated with many adverse outcomes. We examined the incidence and risk factors associated with hematoma formation post-CIED implantation, and explored the preventative effect of prophylactic pressure bandaging (PPB) in a large tertiary center.
Methods:
1,091 devices were implanted during October 2011-December 2014. Clinically significant hematomas (CSH) were those that necessitated prolonged admission, including those due to reoperation, and clinically suspicious hematomas were swellings noted by medical/nursing staff. We screened for variables affecting hematoma incidence prior to conducting multivariate logistic regression analyses, one for all hematomas and one for CSH.
Results:
61 hematomas were identified (5.6% of patients), with 12 of those clinically significant (1.1% of patients). Factors significantly increasing the odds of developing any hematoma were stage 2 (odds ratio [OR] = 2.93, 95% confidence interval [CI] [1.08-7.94], P = 0.034) and 3 chronic kidney disease (CKD) (OR = 3.39 [1.20-9.56], P = 0.021), unfractionated heparin/therapeutic enoxaparin (OR = 3.15 [1.22-8.14], P = 0.018), and dual antiplatelets-aspirin + clopidogrel (OR = 2.95 [1.14-7.65], P = 0.026) + other combinations. Body Mass index (BMI) 25.0-29.9 (OR 0.52 [0.28-0.98], P = 0.044) and >30 were associated with decreased hematoma risk (OR 0.43 [0.20-0.91], P = 0.028). Factors significant for CSH formation were unfractionated heparin/therapeutic enoxaparin (OR = 9.55 [1.83-49.84], P = 0.007) and aspirin + clopidogrel (OR = 7.19 [1.01-50.91], P = 0.048). PPB nonsignificantly increased the odds of total hematoma development (OR = 1.53 [0.87-2.69], P = 0.135), and reduced CSH (OR = 0.67 [0.18-2.47], P = 0.547).
Conclusions:
Heparin and dual antiplatelet use remain strong predictors of overall hematoma formation. CKD is a comparatively moderate predictor. BMI > 25 may decrease the risk of hematoma formation. PPB had nonsignificant effects on hematoma development.
Related Concept Videos
01:21Cardiac Catheterization II: Right Heart Catheterization
01:22Aneurysm IV: Nursing Management
01:26Aneurysm III: Interprofessional Care
01:26Cardiac Catheterization IV: Nursing Management
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
01:29Endocarditis IV: Nursing Management