1
|
Khan MZ, Nguyen A, Khan MU, Sattar Y, Alruwaili W, Gonuguntla K, Sohaib Hayat HM, Mendez M, Nassar S, Abideen Asad ZU, Agarwal S, Raina S, Balla S, Nguyen B, Fan D, Darden D, Munir MB. Association of chronic kidney disease and end-stage renal disease with procedural complications and inpatient outcomes of leadless pacemaker implantations across the United States. Heart Rhythm 2024; 21:1695-1702. [PMID: 38574789 DOI: 10.1016/j.hrthm.2024.03.1816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 03/26/2024] [Accepted: 03/29/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND Leadless pacemakers have emerged as a promising alternative to transvenous pacemakers in patients with kidney disease. However, studies investigating leadless pacemaker outcomes and complications based on kidney dysfunction are limited. OBJECTIVE The objective of this study was to evaluate the association of chronic kidney disease (CKD) and end-stage renal disease (ESRD) with inpatient complications and outcomes of leadless pacemaker implantations. METHODS National Inpatient Sample and International Classification of Diseases, Tenth Revision codes were used to identify patients with CKD and ESRD who underwent leadless pacemaker implantations in the United States from 2016 to 2020. Study end points assessed included inpatient complications, outcomes, and resource utilization of leadless pacemaker implantations. RESULTS A total of 29,005 leadless pacemaker placements were identified. Patients with CKD (n = 5245 [18.1%]) and ESRD (n = 3790 [13.1%]) were younger than patients without CKD and had higher prevalence of important comorbidities. In crude analysis, ESRD was associated with higher prevalence of major complications, peripheral vascular complications, and inpatient mortality. After multivariable adjustment, CKD and ESRD were associated with inpatient mortality (CKD: adjusted odds ratio [aOR], 1.62 [95% CI, 1.40-1.86]; ESRD: aOR, 1.38 [95% CI, 1.18-1.63]) and prolonged length of stay (CKD: aOR, 1.55 [95% CI, 1.46-1.66]; ESRD: aOR, 1.81 [95% CI 1.67-1.96]). ESRD was also associated with higher hospitalization costs (aOR, 1.63; 95% CI, 1.50-1.77) and major complications (aOR, 1.33; 95% CI, 1.13-1.57) after leadless pacemaker implantation. CONCLUSION Approximately one-third of patients undergoing leadless pacemaker implantation had CKD or ESRD. CKD and ESRD were associated with greater length and cost of stay and inpatient mortality.
Collapse
Affiliation(s)
- Muhammad Zia Khan
- Division of Cardiology, West Virginia University Heart and Vascular Institute, Morgantown, West Virginia
| | - Amanda Nguyen
- Department of Medicine, University of California Davis Medical Center, Sacramento, California
| | | | - Yasar Sattar
- Division of Cardiology, West Virginia University Heart and Vascular Institute, Morgantown, West Virginia
| | - Waleed Alruwaili
- Division of Cardiology, West Virginia University Heart and Vascular Institute, Morgantown, West Virginia
| | - Karthik Gonuguntla
- Division of Cardiology, West Virginia University Heart and Vascular Institute, Morgantown, West Virginia
| | - Hafiz Muhammad Sohaib Hayat
- Section of Electrophysiology, Division of Cardiology, University of California Davis, Sacramento, California
| | - Melody Mendez
- Section of Electrophysiology, Division of Cardiology, University of California Davis, Sacramento, California
| | - Sameh Nassar
- Division of Cardiology, West Virginia University Heart and Vascular Institute, Morgantown, West Virginia
| | | | - Siddharth Agarwal
- Division of Cardiology, University of Oklahoma, Oklahoma City, Oklahoma
| | - Sameer Raina
- Division of Cardiology, Stanford University, Stanford, California
| | - Sudarshan Balla
- Division of Cardiology, West Virginia University Heart and Vascular Institute, Morgantown, West Virginia
| | - Bao Nguyen
- Section of Electrophysiology, Division of Cardiology, University of California Davis, Sacramento, California
| | - Dali Fan
- Section of Electrophysiology, Division of Cardiology, University of California Davis, Sacramento, California
| | - Douglas Darden
- Division of Cardiology, Kansas City Heart Rhythm Institute, Overland Park, Kansas
| | - Muhammad Bilal Munir
- Section of Electrophysiology, Division of Cardiology, University of California Davis, Sacramento, California.
| |
Collapse
|
2
|
Zhang J, Shang S, Dong Z, Zhou X, Li Y, Lu Y, Xing Q, Tuerhong Z, Guo Y, Xiaokereti J, Tang B. A case of endocardial dissection caused by Micra implantation. BMC Cardiovasc Disord 2024; 24:10. [PMID: 38166609 PMCID: PMC10763407 DOI: 10.1186/s12872-023-03550-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 10/08/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Leadless pacemakers are a recent technological advancement. It has many advantages, but there are still a few serious complications. CASE PRESENTATION This article reports the case of a patient with an endocardial tear and dissection caused by contact with the tip of the Micra cup during surgery and summarises the relevant data. CONCLUSIONS This case report details the occurrence and management of the incident and provides some guidance for future clinical management.
Collapse
Affiliation(s)
- Jianghua Zhang
- Department of Pacing and Electrophysiology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
- Xinjiang Key Laboratory of Cardiac Electrophysiology and Remodeling, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Shuai Shang
- Department of Pacing and Electrophysiology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
- Xinjiang Key Laboratory of Cardiac Electrophysiology and Remodeling, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Zhenyu Dong
- Department of Pacing and Electrophysiology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
- Xinjiang Key Laboratory of Cardiac Electrophysiology and Remodeling, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Xianhui Zhou
- Department of Pacing and Electrophysiology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
- Xinjiang Key Laboratory of Cardiac Electrophysiology and Remodeling, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Yaodong Li
- Department of Pacing and Electrophysiology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
- Xinjiang Key Laboratory of Cardiac Electrophysiology and Remodeling, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Yanmei Lu
- Department of Pacing and Electrophysiology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
- Xinjiang Key Laboratory of Cardiac Electrophysiology and Remodeling, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Qiang Xing
- Department of Pacing and Electrophysiology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
- Xinjiang Key Laboratory of Cardiac Electrophysiology and Remodeling, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Zukela Tuerhong
- Department of Pacing and Electrophysiology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
- Xinjiang Key Laboratory of Cardiac Electrophysiology and Remodeling, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Yankai Guo
- Department of Pacing and Electrophysiology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
- Xinjiang Key Laboratory of Cardiac Electrophysiology and Remodeling, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Jiasuoer Xiaokereti
- Department of Pacing and Electrophysiology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
- Xinjiang Key Laboratory of Cardiac Electrophysiology and Remodeling, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Baopeng Tang
- Department of Pacing and Electrophysiology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.
- Xinjiang Key Laboratory of Cardiac Electrophysiology and Remodeling, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.
| |
Collapse
|
3
|
Laczay B, Aguilera J, Cantillon DJ. Leadless cardiac ventricular pacing using helix fixation: Step-by-step guide to implantation. J Cardiovasc Electrophysiol 2023; 34:748-759. [PMID: 36542756 DOI: 10.1111/jce.15785] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 12/01/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Leadless cardiac pacemakers are an alternative modality to traditional transvenous pacemaker systems. Recently receiving Food and Drug Administration approval, the AVEIR VR leadless pacemaker system provides a helix based active fixation leadless pacemaker system. This step-by-step review will cover patient selection, preprocedural planning, device implantation technique, implant site evaluation, troubleshooting, short- and long-term complications as well as future directions for leadless pacing. METHODS We collected and reviewed cases from primary operators to provide a step-by-step review for implanters. RESULTS Our paper provides a guide to patient selection, pre-procedural planning, device im plantation technique, implant site evaluation, troubleshooting, short- and long-term complications as well as future directions for leadless pacing. CONCLUSION The helix based active fixation leadless pacemaker system is a safe and efficacious way to provide pacing support to patients and provides an alternative to transvenous pacing systems. Our review provides a step-by-step guide to implantation.
Collapse
Affiliation(s)
- Balint Laczay
- Heart, Vascular, and Thoracic Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Jose Aguilera
- Heart, Vascular, and Thoracic Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Daniel J Cantillon
- Heart, Vascular, and Thoracic Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| |
Collapse
|