Predictors of Early Cardiac Implantable Electronic Device Lead Dislodgement in the Elderly

Rafal Mlynarski, Agnieszka Mlynarska (), Michal Joniec, Sylwia Gladysz-Wanha, Maciej Honkowicz, Joanna Stachanczyk and Krzysztof S. Golba
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Rafal Mlynarski: Department of Electroradiology, School of Health Sciences, Medical University of Silesia, 40-635 Katowice, Poland
Agnieszka Mlynarska: Department of Electrocardiology, Upper Silesian Heart Centre, 40-635 Katowice, Poland
Michal Joniec: Department of Electrocardiology, Upper Silesian Heart Centre, 40-635 Katowice, Poland
Sylwia Gladysz-Wanha: Department of Electrocardiology, Upper Silesian Heart Centre, 40-635 Katowice, Poland
Maciej Honkowicz: Department of Electroradiology, School of Health Sciences, Medical University of Silesia, 40-635 Katowice, Poland
Joanna Stachanczyk: Department of Cardiac Rehabilitation, Murcki Hospital, 40-749 Katowice, Poland
Krzysztof S. Golba: Department of Electrocardiology, Upper Silesian Heart Centre, 40-635 Katowice, Poland

IJERPH, 2022, vol. 19, issue 22, 1-9

Abstract: Introduction: One of the most frequent cardiac implantable electronic device (CIED) implantation complications is lead dislodgement, especially in the older adult population. Little evidence is available about the influence of frailty on the risk of lead dislodgment after CIED implantation procedures; thus, the evaluation of frailty could be relevant for the course and safety of the implantation procedure, especially among the elderly with cardiovascular diseases. This study aimed to assess the risks and predictors of early lead dislodgement in the elderly population. Methods: Between 2008 and 2021, 14,293 patients underwent implantations. In 400 elderly patients, lead dislodgement was confirmed, and frailty was retrospectively calculated. Results: The most frequent dislodgement according to the lead position was that of the atrial lead (133; 33.3%). In the logistic regression, frailty (OR: 1.8196, 95% CI:1.4991–2.2086; p < 0.0001) and age (OR: 1.0315, 95% CI:1.0005–1.0634; p < 0.0461) were independent predictors of early dislodgement. In the female group, frailty (OR: 2.1185, 95% CI: 1.5530–2.8899; p < 0.0001) was an independent predictor of early dislodgement. Similarly, in the male group, frailty (OR: 1.6321, 95% CI:1.2725–2.0934; p < 0.0001) was an independent predictor of early dislodgement. Conclusion: Lead dislodgement often occurs in the elderly. Frailty in both men and women is a predictive factor of early lead dislodgment. Evaluating frailty may be an essential element of proper selection, especially in the elderly undergoing CIED procedures, and, consequently, it could help prevent further complications.

Keywords: CIED implantation complications; lead dislodgement; elderly; frailty (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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