Incidence, predictors, and outcomes associated with pneumothorax during cardiac electronic device implantation: A 16-year review in over 3.7 million patients

Ogunbayo, Gbolahan; Charnigo, Richard; Darrat, Yousef; Morales, Gustavo; Kotter, John; Olorunfemi, Odunayo; Elbadawi, Ayman; Sorrell, Vincent L.; Smyth, Susan S.; Elayi, Claude S.

doi:10.1016/j.hrthm.2017.07.024

Cited by 31 publications

(32 citation statements)

References 28 publications

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“…Variables collected include demographics, prior medical history, and Elixhauser comorbidities as defined by the Agency for Healthcare Research and Quality and using ICD codes and clinical classification software (CCS) codes as defined in the NIS database. The CCS codes have been used to define groups of medical conditions in prior studies …”

Section: Methodsmentioning

confidence: 99%

Safety of catheter ablation for atrial fibrillation in the octogenarian population

Romero

Ogunbayo²,

Elayi³

et al. 2019

Cardiovasc electrophysiol

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Introduction Catheter ablation (CA) has been shown to be an effective treatment for atrial fibrillation (AF). The complication rates and outcomes among octogenarians remain poorly studied. We aimed to compare trends, morbidity, and mortality associated with CA for AF among octogenarians versus those less than 80 years old. Methods Using weighted sampling from the National Inpatient Sample database, we identified patients with a primary diagnosis of AF and a primary procedure of CA (2004‐2013). Our primary outcome was mortality. Secondary outcomes included incidence of major and minor complications. Results Among 86,119 patients who underwent CA for AF, 3,482 were 80 years old or older. Complications were significantly more frequent in octogenarians; [16.2% (564 of 3,482) versus 9.8% (8,092 of 82,637), P < 0.001]. Of note, there was no significant difference for the composite of major complications; [3.6% (124 of 3482) in octogenarians versus 2.8% (2286 of 82637), P = 0.20]. The total mortality rate was not significant in a multivariate regression analysis (odds ratio [OR], 0.96; 95% confidence interval [CI], 0.35‐2.64; P = .94). The presence of chronic renal failure (OR, 4.19; 95% CI, 2.75‐6.36; P < 0.001), anemia (OR, 1.75; 95% CI, 1.03‐2.97; P = .04), and chronic pulmonary disease (OR, 1.75; 95% CI, 1.11‐2.62; P = .015) were predictors of major complications in octogenarians. Conclusion Catheter ablation for AF in octogenarians does not confer a higher mortality risk than in those less than 80 years old. The procedure is associated with a higher rate of overall complications but there was no difference in terms of major complications or death. The presence of anemia, CKD or pulmonary disease were predictors of major complications in octogenarians.

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Section: Methodsmentioning

confidence: 99%

Safety of catheter ablation for atrial fibrillation in the octogenarian population

Romero

Ogunbayo²,

Elayi³

et al. 2019

Cardiovasc electrophysiol

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“…We described baseline characteristics and outcomes using ICD‐9‐CM codes, Clinical Classifications Software (CCS), and NIS documentation (extracted using ICD codes). The CCS categories have been used to group medical conditions in previous studies . We identified patients' baseline and clinical characteristics (inpatient outcomes, procedures, and disposition), comparing male with female patients.…”

Section: Methodsmentioning

confidence: 99%

“…The CCS categories have been used to group medical conditions in previous studies. 18,19 We identified patients' baseline and clinical characteristics (inpatient outcomes, procedures, and disposition), comparing male with female patients.…”

Section: Patient Populationmentioning

confidence: 99%

Sex differences in the contemporary management of HIV patients admitted for acute myocardial infarction

Ogunbayo

Bidwell

Misumida

et al. 2018

Clinical Cardiology

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“…There are many other benefits that make S‐ICD an attractive option. Pneumothorax and cardiac perforation, two of the potentially serious complications associated with conventional S‐ICDs, are avoided in S‐ICD implants . Furthermore, because the shocking electrode is not in direct contact with the endocardium, there is less risk for electroporation and potential cardiac damage during shocks delivered by S‐ICD .…”

Section: Introductionmentioning

confidence: 99%

“…Pneumothorax and cardiac perforation, two of the potentially serious complications associated with conventional S-ICDs, are avoided in S-ICD implants. 4,5 Furthermore, because the shocking electrode is not in direct contact with the endocardium, there is less risk for electroporation and potential cardiac damage during shocks delivered by S-ICD. 6,7 S-ICD implantation requires a minimum of two incisions 8 but usually three (one lateral incision and two parasternal incisions), while a conventional transvenous ICD implantation requires only a single incision.…”

Section: Introductionmentioning

confidence: 99%

Single incision technique for implantation of subcutaneous implantable cardioverter defibrillators

Darrat

Benn

Salih

et al. 2018

Pacing Clinical Electrophis

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Background Subcutaneous implantable cardioverter defibrillators (S‐ICDs) have gained increasing popularity because of certain advantages over transvenous ICDs. However, while conventional ICDs require a single surgical incision to implant, S‐ICDS need two or three incisions, making them less appealing. Objective This study sought out to investigate the feasibility of using a single‐incision technique to implant S‐ICDs. Methods Patients qualifying for S‐ICDs were considered for a single incision. A single incision is performed by making a left inframammary incision and then the subcutaneous tissue is dissected medially toward the lower sternum. Two sutures are placed in the fascia in the xiphoid area to anchor the lead and a tunneling tool is used to dissect the tissue to place the lead parallel to the sternum. Then subcutaneous tissues are dissected down the lateral chest wall over the muscle fascia to create the pulse generator pocket in the vicinity of the fifth and sixth intercostal spaces and near the mid‐axillary line. Results Eleven patients (six males and five females) successfully underwent S‐ICD implantation with a single incision without acute complications (64% for primary prevention). The mean age is 47.4 ± 15.8 years. There were no lead dislodgements, inappropriate shocks, or any other issues during a median follow‐up of 10 months (interquartile range 5–17). One patient had a successful appropriate shock for ventricular fibrillation about one year after device implant. Conclusions A single incision for subcutaneous ICDs is feasible and safe in our early experience.

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Incidence, predictors, and outcomes associated with pneumothorax during cardiac electronic device implantation: A 16-year review in over 3.7 million patients

Cited by 31 publications

References 28 publications

Safety of catheter ablation for atrial fibrillation in the octogenarian population

Safety of catheter ablation for atrial fibrillation in the octogenarian population

Sex differences in the contemporary management of HIV patients admitted for acute myocardial infarction

Single incision technique for implantation of subcutaneous implantable cardioverter defibrillators

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