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Cited by 58Cardiac pacing and defibrillation studiesInfective Endocarditis Diagnosis and ManagementCoronary Interventions and Diagnostics

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Risk Factors Influencing Complications of Cardiac Implantable Electronic Device Implantation: Infection, Pneumothorax and Heart Perforation A Nationwide Population-Based Cohort Study

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Lin, Yu-Sheng, Hung, Sheng-Ping, Chen, Pei-Rung, Yang, Chia-Hung, Wo, Hung-Ta, Chang, Po-Cheng, Wang, Chun-Chieh, Chou, Chung-Chuan, Wen, Ming-Shien, Chung, Chang-Ming, Chen, Tien-Hsing·2014·Medicine
DOI 10.1097/md.0000000000000213PMC PMC4602772
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Abstract

As the number of cardiac implantable electronic devices (CIEDs) is increasing annually, CIED-related complications are becoming increasingly important. The aim of the study was to assess the risks associated with CIEDs by a nationwide database. Patients were selected from the Taiwan National Health Insurance Database. Admissions for CIED implantation, replacement, and revision were evaluated and the evaluation period was 14 years. Endpoints included CIED-related infection, pneumothorax, and heart perforation. The study included 40,608 patients with a mean age of 71.8 ± 13.3 years. Regarding infection, the incidence rate was 2.45 per 1000 CIED-years. Male gender, younger age, device replacement, and previous infection were risks for infection while old age and high-volume centers (>200 per year) were protectors. The incidence of pneumothorax was 0.6%, with an increased risk in individuals who had chronic obstructive lung disease (COPD) and cardiac resynchronized therapy (CRT). The incidence of heart perforation was 0.09%, with an increased risk in individuals who had pre-operation temporal pacing and steroid use. High-volume center was found to decrease infection rate while male gender, young people, and individuals who underwent replacements were associated with an increased risk of infection. Additionally, pre-operation temporal pacing and steroid use should be avoided if possible. Furthermore, COPD patients or those who accept CRTs should be monitored closely.

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FIGURE 1 Time to cardiac implantable electronic device (CIED) infection event.
FIGURE 1 Time to cardiac implantable electronic device (CIED) infection event.CC BY-NC-ND · PubMed Central

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Metadata

Authors
Lin, Y.-S., Hung, S.-P., Chen, P.-R., Yang, C.-H., Wo, H.-T., Chang, P.-C., Wang, C.-C., Chou, C.-C., Wen, M.-S., Chung, C.-M., & Chen, T.-H.
Affiliations
Chang Gung University (TW)
Corresponding author
  • Chen, Pei-Rung
  • Chang, Po-Cheng
  • Chen, Tien-Hsing
ORCID
Venue
Medicine
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2014-12
Volume
93
Issue
27
Pages
e213
ISSN
0025-7974 (ISSN-L)
DOI
10.1097/md.0000000000000213
PMC
PMC4602772
OpenAlex
W2230393603
Cited by
58
References
0
Citations by year
2026: 3 · 2025: 2 · 2024: 6 · 2023: 9 · 2022: 2 · 2021: 1 · 2020: 10 · 2019: 6 · 2018: 4 · 2017: 5 · 2016: 5 · 2015: 5
FWCI
3.44
Type
journal article
Language
en
Open access
Licence
cc-by-nc-nd
Locations
  • Medicine (publishedVersion, cc-by-nc-nd)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Infective Endocarditis Diagnosis and Management
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Coronary Interventions and Diagnostics
Keywords
cardiac implantable electronic devices, device-related infection, pneumothorax, risk factors, equipment replacement, chronic obstructive pulmonary disease, steroid use, high-volume centers
MeSH terms
Adult, Aged, Aged, 80 and over, Female, Heart Injuries, Humans, Infections, Male, Middle Aged, Pacemaker, Artificial, Pneumothorax, Retrospective Studies, Risk Factors, Taiwan, Incidence, Defibrillators, Implantable, Young Adult

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