Peri-Operative Outcomes Associated With the Placement of Implantable Cardioverter-Defibrillators in Patients With...

Area of Science:

• Cardiology
• Immunology
• Medical Devices

Background:

• Cardiac sarcoidosis (CS) increases risk of life-threatening arrhythmias and sudden cardiac death.
• Implantable cardioverter-defibrillators (ICDs) are used for primary and secondary prevention of sudden death in CS patients.
• Limited data exists on postoperative ICD complication rates in sarcoidosis patients compared to the general population.

Purpose of the Study:

• To evaluate the association of postoperative complications with implantable cardioverter-defibrillators in patients with sarcoidosis.
• To compare complication rates between sarcoidosis patients and the general population undergoing ICD placement.

Main Methods:

• Utilized the National Inpatient Sample (NIS) database from 2010-2019.
• Identified adult patients (≥18 years) who underwent surgical ICD placement using ICD-9 and ICD-10 codes.
• Applied HCUP-provided weights for national estimates and used chi-square tests, ANOVA, and multivariable logistic/linear regression for analysis.

Main Results:

• Analyzed 114,073 patients; 1012 (0.9%) had sarcoidosis.
• Sarcoidosis patients were younger, more likely female, and disproportionately African American with different insurance profiles.
• Significantly lower rates of lead complications (4.2% vs. 6.9%), post-procedure hemorrhage (4.1% vs. 5.5%), and transfusion requirements (2.3% vs. 4.4%) were observed in sarcoidosis patients.

Conclusions:

• Implantable cardioverter-defibrillator placement is a safe procedure for patients with sarcoidosis.
• Sarcoidosis patients experienced significantly lower rates of specific post-ICD placement complications.
• These findings are important, considering the predisposition of sarcoidosis patients to cardiac complications.