Title: End-Stage Renal Disease Predicts Complications in Pacemaker and ICD Implants
Abstract: Journal of Cardiovascular ElectrophysiologyVolume 22, Issue 10 p. 1099-1104 End-Stage Renal Disease Predicts Complications in Pacemaker and ICD Implants CHRISTINE TOMPKINS M.D., CHRISTINE TOMPKINS M.D. University of Rochester Medical Center, Rochester, New YorkSearch for more papers by this authorRHONDALYN MCLEAN M.D., RHONDALYN MCLEAN M.D. Johns Hopkins Medical Institutions, Baltimore, Maryland, USASearch for more papers by this authorALAN CHENG M.D., ALAN CHENG M.D. Johns Hopkins Medical Institutions, Baltimore, Maryland, USASearch for more papers by this authorJEFFREY A. BRINKER M.D., JEFFREY A. BRINKER M.D. Johns Hopkins Medical Institutions, Baltimore, Maryland, USASearch for more papers by this authorJOSEPH E. MARINE M.D., JOSEPH E. MARINE M.D. Johns Hopkins Medical Institutions, Baltimore, Maryland, USASearch for more papers by this authorSAMAN NAZARIAN M.D., SAMAN NAZARIAN M.D. Johns Hopkins Medical Institutions, Baltimore, Maryland, USASearch for more papers by this authorDAVID D. SPRAGG M.D., DAVID D. SPRAGG M.D. Johns Hopkins Medical Institutions, Baltimore, Maryland, USASearch for more papers by this authorSUNIL SINHA M.D., SUNIL SINHA M.D. Johns Hopkins Medical Institutions, Baltimore, Maryland, USASearch for more papers by this authorHENRY HALPERIN M.D., HENRY HALPERIN M.D. Johns Hopkins Medical Institutions, Baltimore, Maryland, USASearch for more papers by this authorGORDON F. TOMASELLI M.D., GORDON F. TOMASELLI M.D. Johns Hopkins Medical Institutions, Baltimore, Maryland, USASearch for more papers by this authorRONALD D. BERGER M.D., Ph.D., RONALD D. BERGER M.D., Ph.D. Johns Hopkins Medical Institutions, Baltimore, Maryland, USASearch for more papers by this authorHUGH CALKINS M.D., HUGH CALKINS M.D. Johns Hopkins Medical Institutions, Baltimore, Maryland, USASearch for more papers by this authorCHARLES A. HENRIKSON M.D., M.P.H., CHARLES A. HENRIKSON M.D., M.P.H. Johns Hopkins Medical Institutions, Baltimore, Maryland, USASearch for more papers by this author CHRISTINE TOMPKINS M.D., CHRISTINE TOMPKINS M.D. University of Rochester Medical Center, Rochester, New YorkSearch for more papers by this authorRHONDALYN MCLEAN M.D., RHONDALYN MCLEAN M.D. Johns Hopkins Medical Institutions, Baltimore, Maryland, USASearch for more papers by this authorALAN CHENG M.D., ALAN CHENG M.D. Johns Hopkins Medical Institutions, Baltimore, Maryland, USASearch for more papers by this authorJEFFREY A. BRINKER M.D., JEFFREY A. BRINKER M.D. Johns Hopkins Medical Institutions, Baltimore, Maryland, USASearch for more papers by this authorJOSEPH E. MARINE M.D., JOSEPH E. MARINE M.D. Johns Hopkins Medical Institutions, Baltimore, Maryland, USASearch for more papers by this authorSAMAN NAZARIAN M.D., SAMAN NAZARIAN M.D. Johns Hopkins Medical Institutions, Baltimore, Maryland, USASearch for more papers by this authorDAVID D. SPRAGG M.D., DAVID D. SPRAGG M.D. Johns Hopkins Medical Institutions, Baltimore, Maryland, USASearch for more papers by this authorSUNIL SINHA M.D., SUNIL SINHA M.D. Johns Hopkins Medical Institutions, Baltimore, Maryland, USASearch for more papers by this authorHENRY HALPERIN M.D., HENRY HALPERIN M.D. Johns Hopkins Medical Institutions, Baltimore, Maryland, USASearch for more papers by this authorGORDON F. TOMASELLI M.D., GORDON F. TOMASELLI M.D. Johns Hopkins Medical Institutions, Baltimore, Maryland, USASearch for more papers by this authorRONALD D. BERGER M.D., Ph.D., RONALD D. BERGER M.D., Ph.D. Johns Hopkins Medical Institutions, Baltimore, Maryland, USASearch for more papers by this authorHUGH CALKINS M.D., HUGH CALKINS M.D. Johns Hopkins Medical Institutions, Baltimore, Maryland, USASearch for more papers by this authorCHARLES A. HENRIKSON M.D., M.P.H., CHARLES A. HENRIKSON M.D., M.P.H. Johns Hopkins Medical Institutions, Baltimore, Maryland, USASearch for more papers by this author First published: 13 April 2011 https://doi.org/10.1111/j.1540-8167.2011.02066.xCitations: 82 Charles Henrikson, M.D., M.P.H., Division of Cardiology, Electrophysiology, Johns Hopkins Medical Institution, Medical Center, 600 N. Wolfe Street/Carnegie 592, Baltimore, MD 21287, USA. Fax: +410-955-0223; E-mail: [email protected] Dr. Calkins reports research support from St. Jude Medical, Medtronic, and Boston Scientific. Dr. Cheng reports serving as a consultant to or on the advisory boards of Biotronik and Medtronic. Other authors: No disclosures. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Abstract End-Stage Renal Disease Predicts Complications in Pacemaker and ICD Implants. Introduction: Patients with chronic kidney disease (CKD) have increased morbidity following invasive procedures. We hypothesized that patients with CKD have higher complication rates following device implantation than patients with normal renal function. Methods: We reviewed the medical records of patients undergoing ICD or pacemaker implantation from August 2004 to August 2007. The estimated glomerular filtration rate (GFR) was calculated using the Cockroft–Gault equation. Those with GFR ≥ 90 cc/min served as controls. The remainder was grouped according to American Kidney Foundation stages of CKD. Bleeding complications were defined as need for pocket exploration or blood transfusion; cardiac tamponade; or hematoma requiring pressure dressing, change in medications or prolonged hospitalization. Infection was defined as infection of the pocket or lead system, or development of bacteremia/sepsis within 60 days. Results: There were 82 bleeding complications (5.7%) and 7 infections (0.5%) temporally related to device implantation in 1,440 patients. End-stage renal disease (ESRD), defined as GFR < 15 mL/min or need for dialysis, was identified in 32 patients. Infection rates were significantly higher in patients with ESRD versus controls (12.5% vs 0.2%; P < 0.0001). A significant increase in bleeding complications was observed in ESRD versus controls (21.9% vs 3.2%, respectively; P<0.0001). Bleeding complications were considerably greater than controls in moderate (GFR 30–59 mL/min) and severe (GFR 15–29 mL/min) CKD (7.4% and 9.8% vs 3.2%, respectively; P < 0.005). Conclusion: ESRD markedly increases bleeding and device-related infections. The risk of both complications parallels the severity of CKD. Further research is needed to reduce adverse outcomes in this high-risk population. (J Cardiovasc Electrophysiol, Vol. 22, pp. 1099-1104, October 2011) Citing Literature Volume22, Issue10October 2011Pages 1099-1104 RelatedInformation
Publication Year: 2011
Publication Date: 2011-04-13
Language: en
Type: article
Indexed In: ['crossref', 'pubmed']
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Cited By Count: 111
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