Aging and cardiac implantable electronic device complications: is the procedure safe in older patients?

Area of Science:

• Cardiology
• Medical Devices
• Geriatric Medicine

Background:

• Cardiac implantable electronic devices (CIEDs) are crucial for managing various cardiac conditions.
• Assessing procedural complication risks in elderly populations is vital for patient safety.
• This study compares complication incidence in patients aged ≥75 years versus <75 years undergoing CIED procedures.

Purpose of the Study:

• To determine if older patients (≥75 years) experience a higher incidence of complications following cardiac implantable electronic device (CIED) procedures compared to younger patients (<75 years).

Main Methods:

• A retrospective cohort study was conducted involving 1923 patients who underwent CIED procedures between January 2011 and May 2023.
• Patients were stratified into two groups: <75 years and ≥75 years.
• The primary composite endpoint included clinically significant hematoma, pericardial effusion/tamponade, pneumothorax, and device-related infection.

Main Results:

• No significant difference was observed in the overall primary composite endpoint between the age groups (3.5% vs. 4.4%, p=0.393).
• Device-related infection rates were significantly higher in the older group (1.8% vs. 3.4%, p=0.034).
• No significant differences were found for clinically significant hematoma or pneumothorax between the age groups.

Conclusions:

• Infection rates were notably higher in patients aged 75 years and older.
• This elderly patient group requires heightened vigilance for infection development, both before and after CIED procedures.
• Multivariate analysis did not identify age ≥75 years as an independent risk factor for device-related infection.