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Complications after implants of cardiac electronic device in acute heart failure

Session Poster Session 3

Speaker Associate Professor Luiz Carlos Passos

Event : Heart Failure 2019

  • Topic : heart failure
  • Sub-topic : Acute Heart Failure – Epidemiology, Prognosis, Outcome
  • Session type : Poster Session

Authors : LCSP Passos (Salvador,BR), AGQJ Grimaldi (Salvador,BR), TM Trindade (Salvador,BR), TC Silva (Salvador,BR), WC Neves (Salvador,BR), AC Guimaraes (Salvador,BR), EG Lopes (Salvador,BR), A Seabra (Salvador,BR), MC Dantas (Salvador,BR), ILS Santana (Salvador,BR), DC Monteiro (Salvador,BR), HM Santos (Salvador,BR), VO Santos (Salvador,BR), L Kassia (Salvador,BR), MV Barreto (Salvador,BR)

Authors:
LCSP Passos1 , AGQJ Grimaldi2 , TM Trindade2 , TC Silva2 , WC Neves2 , AC Guimaraes2 , EG Lopes2 , A Seabra2 , MC Dantas2 , ILS Santana2 , DC Monteiro2 , HM Santos2 , VO Santos2 , L Kassia2 , MV Barreto2 , 1Federal University of Bahia, Internal Medicine - Salvador - Brazil , 2Ana Nery Hospital - Salvador - Brazil ,

On behalf: EPICO - Estudo para Investigação de Causas Tratáveis e Otimização terapêutica da Insuficiência Cardíaca

Citation:

BACKGROUND: Acute Heart Failure (AHF) is the most common cause of hospitalization among the elderly in the Unified Health System (SUS) and is associated with high morbidity and mortality rates. In the last decades, Cardiac Resynchronization Therapy (CRT) and Implantable Cardioverter Defibrillators (ICD) are non-pharmacological and adjunctive therapy options that have become increasingly common.The assessment and decision of implantation of cardiac devices may occur in a scheduled outpatient setting or during hospitalization for decompensation of HF.Patients often have a form of severe disease with frequent episodes of AHF and the implant may be related to a good long-term prognosis but may also be related to severe complicationsin the short term.

OBJETIVE: The aim of the study is to describe the complications after implantation of theseelectronic devices of high risk of Acute Heart Failure.

METHODS: A prospective cohort study of patients who were admitted for AHF and implanted some electronic cardiac device (DEIC) from May 2017 at the state center of reference for implantation of devices by the Unified Health System of the state of Bahia.Heart failure (HF) was defined according to the guidelines of the European Society of Cardiology (ESC) and only cases of systolic heart failure, defined as Left Ventricular Ejection Fraction (LVEF) <50% were evaluated. Clinical, laboratory, drug, and other data were collected from medical records.

RESULTS: Were analyzed 65 patients hospitalized to AHF and who needed to perform the implantation of some high cost cardiac electronic device: ICD 78% (51), 6% (4) CRT-P or 15% (10) CRT-D. The mean age was 56 years, 74% (48) males, 15% (10) patients with ischemic heart disease and 46% (30) Chagas' disease. Of these, 37% (24) developed acute renal failure, 6% (4) had hematoma, and 6% (4) had infection.  1.5% (1) developed pneumothorax, 1.5% (1) had electrode displacement followed device explants (4% - 3). The mean time of hospitalization was 15 days and 6.25% (4) patients died in the hospital, and 4.6% (3) patients died within 1 year of discharge.

CONCLUSIONS: These findings suggest that the implantation of these devices during hospitalization for AHF appears to offer additional risks of serious complications such as infection followed by explants and  untildeath.

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