Comparison of infection and complication rates associated with transvenous vs. subcutaneous defibrillators in patients with stage 4 chronic kidney disease: a multicenter long-term retrospective follow-up
BackgroundPatients with progressive chronic kidney disease (CKD) are at higher risk of infections and complications from cardiac implantable electronic devices (CIED). In patients with a primary or secondary prophylactic indication, implantable cardiac defibrillators (ICD) can prevent sudden cardiac...
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| Format: | Article |
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Frontiers Media S.A.
2024-04-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2024.1397138/full |
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| author | Fabian Schiedat Fabian Schiedat Benjamin Meuterodt Magnus Prull Assem Aweimer Michael Gotzmann Stephen O’Connor Christian Perings Johannes Korth Thomas Lawo Ibrahim El-Battrawy Ibrahim El-Battrawy Christoph Hanefeld Andreas Mügge Andreas Mügge Axel Kloppe Axel Kloppe |
| author_facet | Fabian Schiedat Fabian Schiedat Benjamin Meuterodt Magnus Prull Assem Aweimer Michael Gotzmann Stephen O’Connor Christian Perings Johannes Korth Thomas Lawo Ibrahim El-Battrawy Ibrahim El-Battrawy Christoph Hanefeld Andreas Mügge Andreas Mügge Axel Kloppe Axel Kloppe |
| author_sort | Fabian Schiedat |
| collection | DOAJ |
| description | BackgroundPatients with progressive chronic kidney disease (CKD) are at higher risk of infections and complications from cardiac implantable electronic devices (CIED). In patients with a primary or secondary prophylactic indication, implantable cardiac defibrillators (ICD) can prevent sudden cardiac deaths (SCD). We retrospectively compared transvenous-ICD (TV-ICD) and intermuscularly implanted subcutaneous-ICD (S-ICD) associated infections and complication rates together with hospitalizations in recipients with stage 4 kidney disease.MethodsWe retrospectively analyzed 70 patients from six German centers with stage 4 CKD who received either a prophylactic TV-ICD with a single right ventricular lead, 49 patients, or a S-ICD, 21 patients. Follow-Ups (FU) were performed bi-annually.ResultsThe TV-ICD patients were significantly older. This group had more patients with a history of atrial arrhythmias and more were prescribed anti-arrhythmic medication compared with the S-ICD group. There were no significant differences for other baseline characteristics. The median and interquartile range of FU durations were 55.2 (57.6–69.3) months. During FU, patients with a TV-ICD system experienced significantly more device associated infections (n = 8, 16.3% vs. n = 0; p < 0.05), device-associated complications (n = 13, 26.5% vs. n = 1, 4.8%; p < 0.05) and device associated hospitalizations (n = 10, 20.4% vs. n = 1, 4.8%; p < 0.05).ConclusionIn this long-term FU of patients with stage 4 CKD and an indication for a prophylactic ICD, the S-ICD was associated with significantly fewer device associated infections, complications and hospitalizations compared with TV-ICDs. |
| first_indexed | 2024-04-24T11:36:22Z |
| format | Article |
| id | doaj.art-8136d9c4ecbf428db83a6de2e5ef04a2 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-24T11:36:22Z |
| publishDate | 2024-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-8136d9c4ecbf428db83a6de2e5ef04a22024-04-10T05:21:21ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2024-04-011110.3389/fcvm.2024.13971381397138Comparison of infection and complication rates associated with transvenous vs. subcutaneous defibrillators in patients with stage 4 chronic kidney disease: a multicenter long-term retrospective follow-upFabian Schiedat0Fabian Schiedat1Benjamin Meuterodt2Magnus Prull3Assem Aweimer4Michael Gotzmann5Stephen O’Connor6Christian Perings7Johannes Korth8Thomas Lawo9Ibrahim El-Battrawy10Ibrahim El-Battrawy11Christoph Hanefeld12Andreas Mügge13Andreas Mügge14Axel Kloppe15Axel Kloppe16Department of Cardiology and Angiology, UniversityHospital Bergmannsheil Bochum of the Ruhr-University Bochum, Bochum, GermanyDepartment of Cardiology and Angiology at Marienhospital Gelsenkirchen, Academic Hospital of the Ruhr University Bochum, Gelsenkirchen, GermanyDepartment of Cardiology, Electrophysiology, Pneumology and Intensive Care Medicine, St. Marien-Hospital Luenen, Academic Hospital of the University Muenster, Luenen, GermanyDepartment of Cardiology, Augusta Hospital Bochum, Academic Hospital of the University Duisburg-Essen, Bochum, GermanyDepartment of Cardiology and Angiology, UniversityHospital Bergmannsheil Bochum of the Ruhr-University Bochum, Bochum, GermanyDepartment of Cardiology, Katholische Kliniken Bochum of the Ruhr University Bochum, Bochum, GermanyDepartment of Biomedical Engineering, City, University of London, London, United KingdomDepartment of Cardiology, Electrophysiology, Pneumology and Intensive Care Medicine, St. Marien-Hospital Luenen, Academic Hospital of the University Muenster, Luenen, GermanyDepartment of Nephrology, University Hospital Essen, University of Duisburg-Essen, Essen, GermanyDepartment of Cardiology, Elisabeth Hospital Recklinghausen, Recklinghausen, GermanyDepartment of Cardiology and Angiology, UniversityHospital Bergmannsheil Bochum of the Ruhr-University Bochum, Bochum, GermanyDepartment of Molecular and Experimental Cardiology, Institut für Forschung und Lehre (IFL), Ruhr-University Bochum, Bochum, GermanyDepartment of Cardiology, Katholische Kliniken Bochum of the Ruhr University Bochum, Bochum, GermanyDepartment of Cardiology and Angiology, UniversityHospital Bergmannsheil Bochum of the Ruhr-University Bochum, Bochum, GermanyDepartment of Cardiology, Katholische Kliniken Bochum of the Ruhr University Bochum, Bochum, GermanyDepartment of Cardiology and Angiology, UniversityHospital Bergmannsheil Bochum of the Ruhr-University Bochum, Bochum, GermanyDepartment of Cardiology and Angiology at Marienhospital Gelsenkirchen, Academic Hospital of the Ruhr University Bochum, Gelsenkirchen, GermanyBackgroundPatients with progressive chronic kidney disease (CKD) are at higher risk of infections and complications from cardiac implantable electronic devices (CIED). In patients with a primary or secondary prophylactic indication, implantable cardiac defibrillators (ICD) can prevent sudden cardiac deaths (SCD). We retrospectively compared transvenous-ICD (TV-ICD) and intermuscularly implanted subcutaneous-ICD (S-ICD) associated infections and complication rates together with hospitalizations in recipients with stage 4 kidney disease.MethodsWe retrospectively analyzed 70 patients from six German centers with stage 4 CKD who received either a prophylactic TV-ICD with a single right ventricular lead, 49 patients, or a S-ICD, 21 patients. Follow-Ups (FU) were performed bi-annually.ResultsThe TV-ICD patients were significantly older. This group had more patients with a history of atrial arrhythmias and more were prescribed anti-arrhythmic medication compared with the S-ICD group. There were no significant differences for other baseline characteristics. The median and interquartile range of FU durations were 55.2 (57.6–69.3) months. During FU, patients with a TV-ICD system experienced significantly more device associated infections (n = 8, 16.3% vs. n = 0; p < 0.05), device-associated complications (n = 13, 26.5% vs. n = 1, 4.8%; p < 0.05) and device associated hospitalizations (n = 10, 20.4% vs. n = 1, 4.8%; p < 0.05).ConclusionIn this long-term FU of patients with stage 4 CKD and an indication for a prophylactic ICD, the S-ICD was associated with significantly fewer device associated infections, complications and hospitalizations compared with TV-ICDs.https://www.frontiersin.org/articles/10.3389/fcvm.2024.1397138/fullsudden cardiac death (SCD)implantable cardiac defibrillator (ICD)S-ICDdevice infectiondevice complicationchronic kidney disease |
| spellingShingle | Fabian Schiedat Fabian Schiedat Benjamin Meuterodt Magnus Prull Assem Aweimer Michael Gotzmann Stephen O’Connor Christian Perings Johannes Korth Thomas Lawo Ibrahim El-Battrawy Ibrahim El-Battrawy Christoph Hanefeld Andreas Mügge Andreas Mügge Axel Kloppe Axel Kloppe Comparison of infection and complication rates associated with transvenous vs. subcutaneous defibrillators in patients with stage 4 chronic kidney disease: a multicenter long-term retrospective follow-up Frontiers in Cardiovascular Medicine sudden cardiac death (SCD) implantable cardiac defibrillator (ICD) S-ICD device infection device complication chronic kidney disease |
| title | Comparison of infection and complication rates associated with transvenous vs. subcutaneous defibrillators in patients with stage 4 chronic kidney disease: a multicenter long-term retrospective follow-up |
| title_full | Comparison of infection and complication rates associated with transvenous vs. subcutaneous defibrillators in patients with stage 4 chronic kidney disease: a multicenter long-term retrospective follow-up |
| title_fullStr | Comparison of infection and complication rates associated with transvenous vs. subcutaneous defibrillators in patients with stage 4 chronic kidney disease: a multicenter long-term retrospective follow-up |
| title_full_unstemmed | Comparison of infection and complication rates associated with transvenous vs. subcutaneous defibrillators in patients with stage 4 chronic kidney disease: a multicenter long-term retrospective follow-up |
| title_short | Comparison of infection and complication rates associated with transvenous vs. subcutaneous defibrillators in patients with stage 4 chronic kidney disease: a multicenter long-term retrospective follow-up |
| title_sort | comparison of infection and complication rates associated with transvenous vs subcutaneous defibrillators in patients with stage 4 chronic kidney disease a multicenter long term retrospective follow up |
| topic | sudden cardiac death (SCD) implantable cardiac defibrillator (ICD) S-ICD device infection device complication chronic kidney disease |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2024.1397138/full |
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