Skin Thickness Over Cardiac Implantable Electronic Devices: Prognostic Impact and Longitudinal Changes

Area of Science:

• Cardiology
• Medical Devices
• Dermatology

Background:

• Skin thinning over cardiac implantable electronic devices (CIEDs) is common but its clinical significance and progression are not well understood.
• Investigating skin thickness over CIEDs is crucial for understanding patient outcomes.

Purpose of the Study:

• To assess the clinical significance of skin thickness over CIEDs.
• To examine the association between skin thickness and adverse outcomes like mortality and infections.
• To evaluate temporal changes in skin thickness and related clinical factors.

Main Methods:

• Ultrasonographic measurement of skin thickness over CIEDs in 96 patients.
• Monitoring of adverse outcomes including mortality and device infections.
• Follow-up ultrasonography in 34 patients to assess temporal changes.

Main Results:

• Skin thickness significantly declined over time (median 42 months), correlated with hemoglobin levels.
• Patients with skin thickness ≤ 3.3 mm had significantly higher all-cause mortality (log-rank p < 0.001).
• Skin thickness ≤ 3.3 mm was an independent predictor of mortality (HR 2.42, p = 0.046); infections were more frequent but not significant.

Conclusions:

• Skin thickness over CIEDs progressively declines and correlates with hemoglobin.
• Reduced skin thickness (≤ 3.3 mm) is independently associated with increased all-cause mortality.
• Skin thickness is a clinically significant indicator of outcomes in patients with CIEDs.