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Simpson J, Yoder M, Christian-Miller N, Wheat H, Kovacs B, Cunnane R, Ghannam M, Liang JJ. Long-Term Complications Related to Cardiac Implantable Electronic Devices. J Clin Med 2025; 14:2058. [PMID: 40142866 PMCID: PMC11942853 DOI: 10.3390/jcm14062058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2025] [Revised: 03/08/2025] [Accepted: 03/13/2025] [Indexed: 03/28/2025] Open
Abstract
Cardiac implantable electronic devices (CIEDs) are commonly used for a number of cardiac-related conditions, and it is estimated that over 300,000 CIEDs are placed annually in the US. With advances in technology surrounding these devices and expanding indications, CIEDs can remain implanted in patients for long periods of time. Although the safety profile of these devices has improved over time, both the incidence and prevalence of long-term complications are expected to increase. This review highlights pertinent long-term complications of CIEDs, including lead-related issues, device-related arrhythmias, inappropriate device therapies, and device-related infections. We also explore key clinical aspects of each complication, including common presentations, patient-specific and non-modifiable risk factors, diagnostic evaluation, and recommended management strategies. Our goal is to help spread awareness of CIED-related complications and to empower physicians to manage them effectively.
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Affiliation(s)
- Jamie Simpson
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA; (J.S.); (M.Y.); (N.C.-M.)
| | - Mason Yoder
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA; (J.S.); (M.Y.); (N.C.-M.)
| | - Nathaniel Christian-Miller
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA; (J.S.); (M.Y.); (N.C.-M.)
| | - Heather Wheat
- Department of Clinical Electrophysiology, Frankel Cardiovascular Center, University of Michigan, Ann Arbor, MI 48109, USA; (H.W.); (B.K.); (R.C.); (M.G.)
| | - Boldizsar Kovacs
- Department of Clinical Electrophysiology, Frankel Cardiovascular Center, University of Michigan, Ann Arbor, MI 48109, USA; (H.W.); (B.K.); (R.C.); (M.G.)
| | - Ryan Cunnane
- Department of Clinical Electrophysiology, Frankel Cardiovascular Center, University of Michigan, Ann Arbor, MI 48109, USA; (H.W.); (B.K.); (R.C.); (M.G.)
| | - Michael Ghannam
- Department of Clinical Electrophysiology, Frankel Cardiovascular Center, University of Michigan, Ann Arbor, MI 48109, USA; (H.W.); (B.K.); (R.C.); (M.G.)
| | - Jackson J. Liang
- Department of Clinical Electrophysiology, Frankel Cardiovascular Center, University of Michigan, Ann Arbor, MI 48109, USA; (H.W.); (B.K.); (R.C.); (M.G.)
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Mohan B, Batta A. Dual-chamber pacing confers better myocardial performance and improves clinical outcomes compared to single-chamber pacing. World J Cardiol 2024; 16:626-631. [PMID: 39600992 PMCID: PMC11586728 DOI: 10.4330/wjc.v16.i11.626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2024] [Revised: 09/29/2024] [Accepted: 10/15/2024] [Indexed: 10/30/2024] Open
Abstract
The deleterious effects of long term right ventricular pacing are increasingly being recognized today. Current clinical practice favors the implantation of dual-chamber permanent pacemaker which maintains atrioventricular synchrony and is associated with better quality of life. However, despite the popular belief and common sense surrounding the superiority of dual-chamber pacing over single chamber pacing, the same has never been conclusively verified in clinical trials. Some observational evidence however, does exists which supports the improved cardiac hemodynamics, lower the rate of atrial fibrillation, heart failure and stroke in dual-chamber pacing compared to single-chamber pacing. In the index study by Haque et al, right ventricular pacing, particularly in ventricular paced, ventricular sensed, inhibited response and rate responsive pacemaker adversely impacted the left ventricular functions over 9-months compared to dual pacing, dual sensing, dual responsive and rate responsive pacemaker. Although there are key limitations of this study, these findings does support a growing body of evidence reinstating the superiority of dual chamber pacing compared to single chamber pacing.
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Affiliation(s)
- Bishav Mohan
- Department of Cardiology, Dayanand Medical College and Hospital, Ludhiana 141001, Punjab, India
| | - Akash Batta
- Department of Cardiology, Dayanand Medical College and Hospital, Ludhiana 141001, Punjab, India.
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