Related Experiment Video
Updated: Jan 24, 2026
EPA Method 1615. Measurement of Enterovirus and Norovirus Occurrence in Water by Culture and RT-qPCR. I. Collection of Virus Samples
Published on: March 28, 2015
Occurrence, mortality and predictors of complicated cardiac perforation in patients with CRT-D: Based on the National
Hiro Kawata1, Ashwini Erande1, Ola Lafi1
1Division of Cardiology, Department of Medicine, University of California Irvine Medical Center, Orange, CA, USA.
Insights
Cardiac perforation after Cardiac Resynchronization Therapy Defibrillator (CRT-D) implantation is rare but fatal, with a 10.6% mortality rate. Female patients face increased risk, highlighting the need for physician awareness of patient demographics.
Area of Science:
- Cardiology
- Medical Devices
- Patient Safety
Background:
- Cardiac Resynchronization Therapy Defibrillator (CRT-D) is a vital therapy for cardiomyopathy.
- Cardiac perforation is a rare but potentially fatal complication of CRT-D implantation.
- Limited research exists on cardiac perforation post-CRT-D.
Purpose of the Study:
- To investigate the incidence, mortality, and predictors of cardiac perforation in patients undergoing CRT-D implantation.
- To analyze cardiac perforation rates during the index hospitalization for CRT-D procedures.
Main Methods:
- Utilized the National Inpatient Sample (NIS) dataset (2002-2012).
- Identified patients receiving CRT-D using ICD-9 codes.
- Employed multivariate analyses to determine predictors of cardiac perforation and in-hospital mortality.
Main Results:
- A total of 77,827 patients were analyzed.
- The in-hospital cardiac perforation rate was 0.32%, with a significant increase observed (p=0.02).
- Mortality among patients with cardiac perforation was 10.6%; female sex was an independent risk factor (OR: 2.628, p<0.0001).
Conclusions:
- Cardiac perforation incidence has not improved despite technological advancements in CRT-D implantation.
- Cardiac perforation, though rare, has a high mortality rate, particularly in female patients.
- Physicians must recognize patient comorbidities and demographics associated with higher perforation risk.
Background:
Cardiac Resynchronization Therapy Defibrillator (CRT-D) has been one of the most important therapies for patients with cardiomyopathy over the last decades. Cardiac perforation occurs infrequently but can be fatal. The occurrence of cardiac perforation after CRT-D implantation has not been studied well. The aim of study is to investigate the occurrence, mortality and predictors of cardiac perforation in patients receiving CRT-D during the index hospitalization.
Methods:
Data were obtained from the National Inpatient Sample, the largest all-player inpatient dataset in the United States. Patients who received CRT-D from 2002 to 2012 were identified using ICD-9 codes. Multivariate analyses were used to identify predictors of cardiac perforation. Complications including in-hospital death and cardiac perforation were identified using ICD-9 codes.
Results:
A total of 77,827 patients with CRT-D implantation were included into our analysis. After the CRT-D implantation, the in-hospital and rate of cardiac perforation was between 0.24 and 0.48% and had increased significantly (p = 0.02). Although occurrence of cardiac perforation is rare (0.32%), the mortality was 10.6% among those patients with cardiac perforation. In Multivariate analysis identified female as independent risk factors for cardiac perforation (OR: 2.628, 95% CI 1.926-3.585, p < 0.0001).
Conclusion:
Despite rapid progress of the tools and skills for CRT-D implantation, the occurrence of cardiac perforation has not improved. While cardiac perforation is rare, it carries the highest rate of mortality, especially in female patients. Implanting physicians should be familiar with the comorbidities and patient demographics that put them at a higher risk for complications.
More Related Videos
09:16Isolation and Characterization of Cardiac Mesenchymal Stromal Cells from Endomyocardial Bioptic Samples of Arrhythmogenic Cardiomyopathy Patients
Published on: February 28, 2018
04:24A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
Published on: April 19, 2019
Related Concept Videos
01:26National Nursing Organizations I
01:30National Nursing Organizations II
The AACN emphasizes a healthy work environment through six standards to achieve an optimal patient outcome. The standards are appropriate staffing, meaningful recognition, collaboration, authentic leadership, effective communication, and decision-making. In addition, AACN provides certification programs, webinars, journals, and...
01:22Esophageal Perforation-I: Introduction
The location of esophageal perforation can vary, occurring anywhere along the esophagus....
01:21Types of Reports II: Incident or Occurrence Report
Purposes:
In the healthcare industry, reports play a crucial role in documenting incidents within an agency. The primary objective of these reports is to ensure patient safety, uphold the...
01:24Hemodialysis II: Procedure and Complications
01:15Diabetes: Symptoms, Diagnosis, and Complications