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Cardiac device implantations in obese patients: Success rates and complications.

Cardiac device implantations in obese patients: Success rates and complications.
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Attanasio P, Lacour P, Ernert A, Pieske B, Haverkamp W, Blaschke F, Dalle Vedove F, Huemer M,


Attanasio P, Lacour P, Ernert A, Pieske B, Haverkamp W, Blaschke F, Dalle Vedove F, Huemer M, (click to view)

Attanasio P, Lacour P, Ernert A, Pieske B, Haverkamp W, Blaschke F, Dalle Vedove F, Huemer M,

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Clinical cardiology 2017 03 23() doi 10.1002/clc.22650
Abstract
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.

HYPOTHESIS
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/m(2) . 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/m(2) vs 25.1 ± 3.0 kg/m(2) , 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 cGcm(2) vs 2692 ± 5277 cGcm(2) ; P < 0.005). CONCLUSIONS
CIED implantation can be safely and effectively achieved in patients with BMI >30 kg/m(2) . However, total radiation dose was significantly higher in the obese group, emphasizing that efforts should be made to reduce radiation exposure in these patients.

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