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Post procedural complications of cardiac implants done in a resource limited setting under 'C' arm: A single centre
A Jayachandra1, Vivek Aggarwal2, Sandeep Kumar3
1Classified Specialist (Medicine) & Cardiologist, Command Hospital (Northern Command), Udhampur, India.
Insights
Cardiac device implantation in peripheral hospitals is feasible with low complication rates. This study shows that using a C-arm in resource-limited settings can achieve outcomes comparable to advanced centers when aseptic measures are followed.
Area of Science:
- Cardiology
- Medical Interventions
- Peripheral Healthcare
Background:
- Peripheral hospitals face challenges in providing advanced cardiology interventions due to limited resources.
- Arrhythmia and heart blocks/sinus node dysfunction are common causes of sudden cardiac death.
- This study examines cardiac device implantation in a resource-limited peripheral center.
Purpose of the Study:
- To evaluate the post-procedural complications of cardiac device implantation performed under a C-arm in a resource-limited setting.
- To assess the feasibility and safety of cardiac device implantation in peripheral hospitals.
Main Methods:
- A single peripheral cardiology center without a cardiac catheterization laboratory was used.
- Consecutive patients requiring cardiac device implantation between January 2015 and October 2016 were included.
- Procedures were performed in an operation theatre under a C-arm, using local anesthesia with critical care backup.
Main Results:
- A total of 58 device implantations were performed.
- The most common indications were sinus node dysfunction (60.34%) and complete heart block (25.86%).
- No post-procedure infections were observed, indicating a low complication rate.
Conclusions:
- Cardiac device implantation is a vital, life-saving intervention.
- Peripheral centers can achieve complication rates comparable to advanced centers with appropriate aseptic techniques.
- This approach demonstrates the successful delivery of essential cardiac care in underserved areas.
Background:
Cardiology interventions in peripheral hospitals is a challenging task where cardiologist have to fight against time and limited resources. Most of the sudden cardiac deaths occur due to arrhythmia and heart blocks/sinus node dysfunction. Our study is a single peripheral center experience of cardiac devices implantation using a 'C' Arm. The aim of this study was to post procedural complications of cardiac implants done in aresource limited setting under 'C' arm.
Methods:
This study is done at a peripheral cardiology center with no cardiac catheterization laboratory (CCL) facilities. Consecutive patients reporting to cardiology center, between Jan 2015 and Oct 2016, with a definite indication for cardiac device implant were included in the study. All the procedure of implantation was done in the operation theatre under 'C' arm under local anesthesia with continuous cardiac monitoring and critical care back up.
Results:
Total 58 device implantations were done from Jan 2015 to Oct 2016. The mean age of the patients was 67.15 ± 10.85 years. Males constituted almost two third (68.9%) of patients. The commonest indication for device implantation was sinus node dysfunction in 60.34% followed by complete heart block in 25.86% and ventricular tachycardia in 12.06%. No post procedure infection was observed in our study.
Conclusion:
Device implantation constitute a major group of life saving interventions in cardiology practice. Our study has emphasised that when appropriate aseptic measures are taken during device implantation at peripheral centres, the complications rate are comparable to interventions done at advance cardiac centres.