Cardiac device implantations in obese patients: Success rates and complications.
BACKGROUND
Obesity is associated with increased complications and potentially worse outcomes for various cardiac interventions. This study analyzed the success rate and complication rates associated with implantation of cardiac implantable electronic devices (CIEDs) in obese patients.


OBJECTIVE
Success rates are lower and complication rates higher in obese patients.


METHODS
Consecutive patients undergoing CIED implantation between 2011 and 2015 in our hospital were included. Patients were categorized into obese and nonobese groups according to body mass index (BMI); cutoff was 30 kg/m2. Patient characteristics, complication rates, procedural duration, and fluoroscopy data were compared between the 2 groups.


RESULTS
A total of 965 patients (mean age, 69.0 ± 12.9 years; 67% male) were included. Of these, 249 (25.8%) patients were classified obese and 716 (74.2%) nonobese. Mean BMI was 34.7 ± 4.7 kg/m2vs 25.1 ± 3.0 kg/m2, respectively. There was no difference in procedural success rates between the 2 groups (97.2% vs 97.1%, respectively). Major complications were significantly lower in the obese group compared with the nonobese group (11 [4.4%] vs 62 [8.7%]; P < 0.05). Procedural duration and fluoroscopy duration were not different between the 2 groups, but the total dose-area product was significantly higher in obese patients vs nonobese patients (4012 ± 5416 cGcm2vs 2692 ± 5277 cGcm2; P < 0.005).


CONCLUSIONS
CIED implantation can be safely and effectively achieved in patients with BMI >30 kg/m2. However, total radiation dose was significantly higher in the obese group, emphasizing that efforts should be made to reduce radiation exposure in these patients.
Department of Cardiology, Campus Virchow-Klinikum, Charité University Hospital Berlin, Germany.
Philipp
P
Attanasio
Department of Cardiology, Campus Virchow-Klinikum, Charité University Hospital Berlin, Germany.
Philipp
P
Lacour
Department of Biometrics and Clinical Epidemiology, Campus Virchow-Klinikum, Charité University Hospital Berlin, Germany.
Andrea
A
Ernert
Department of Cardiology, Campus Virchow-Klinikum, Charité University Hospital Berlin, Germany.|Department of Cardiology, German Heart Center Berlin, Germany.
Burkert
B
Pieske
Department of Cardiology, Campus Virchow-Klinikum, Charité University Hospital Berlin, Germany.
Wilhelm
W
Haverkamp
Department of Cardiology, Campus Virchow-Klinikum, Charité University Hospital Berlin, Germany.
Florian
F
Blaschke
Department of Medicine, General Medicine and Hypertension, University of Verona, Italy.
Francesco
F
Dalle Vedove
Department of Cardiology, Campus Virchow-Klinikum, Charité University Hospital Berlin, Germany.
Martin
M
Huemer
D000368:Aged; D015992:Body Mass Index; D015897:Comorbidity; D017147:Defibrillators, Implantable; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006333:Heart Failure / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D015994:Incidence; D008297:Male; D009765:Obesity / Q000453:epidemiology*; D010138:Pacemaker, Artificial; D011379:Prognosis; D019919:Prosthesis Implantation / Q000009:adverse effects* / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013997:Time Factors
Obesity, Cardiac implantable electrical devices, CIED, complications, radiation dose