Efficacy of a novel compression tool in preventing complications following device implantation

Pocket haematoma is a common complication of cardiac implantable electronic device (CIED) procedures and may lead to pain, delayed healing, surgical evacuation or infection. Although pressure dressings with adhesive tapes are widely used for haematoma prevention, they can cause skin erosion. Therefore, this study evaluated the efficacy of the Heart band, a novel compression tool, in preventing device implantation-related complications in patients who underwent CIED procedures.

Among 663 consecutive patients who underwent CIED procedures, we retrospectively analysed 532 (compression tool use, n=283; adhesive tape use, n=249) who underwent CIED implantation or generator replacement between April 2019 and March 2021. Either adhesive tape (2019-2020) or the compression tool (2020-2021) was used in the patients. Compression was applied for 2 days postoperatively, and recompression was performed at the physician's discretion if haematoma-related swelling was noted. The primary endpoints were postoperative complications including recompression, haematoma and skin erosion. Intervention-requiring haematoma (IRH) was defined as haematomas for which transfusion or surgical evacuation was necessary.

Skin erosion occurred significantly less often in the compression tool group (0.4% vs 9.6%, p<0.01), whereas there were no significant intergroup differences in the rates of recompression (19.4% (compression tool group) vs 16.1% (adhesive tape group), p=0.36) and IRH (0.7% (compression tool group) vs 0% (adhesive tape group), p=0.50). These trends were consistent in high-risk subgroups, including patients receiving antithrombotic therapy, with diabetes or with implantable cardioverter-defibrillator/cardiac resynchronisation therapy-defibrillator. Multivariate analysis identified the compression tool as an independent negative predictor of skin erosion (OR 0.03, 95% CI <0.01 to 0.26, p<0.01).

The compression tool had efficacy comparable to that of conventional pressure dressing with adhesive tape in preventing IRH. Compression tools are also associated with a lower incidence of skin erosion.