Carcinoid heart disease (CHD) is a rare complication of hormonally active neuroendocrine tumors that often requires surgical intervention. There are limited data on cardiac implantable electronic device (CIED) implantation in patients with CHD.
We evaluated the experience of CIED implantation in patients with CHD.
Patients with a diagnosis of CHD and a CIED procedure from January 1, 1995 through June 1, 2020 were identified using a Mayo Clinic proprietary data retrieval tool. Retrospective review was performed to extract relevant data. These included indications for implant, procedural details, complications, and mortality.
A total of 27 patients (55.6% males, mean age at device implant at 65.6+/- 8.8 years) with a cumulative follow up of 75 patient years (median 1.1, IQR: 0.4-4.6 years) were included for analysis. The majority of implanted devices were dual-chamber permanent pacemakers (63%). Among all CHD patients who underwent any cardiac surgery, the incidence of CIED implantation was 12%. The most common indication for implantation was high-grade heart block (66.7%). Device implant complication rates were modest (14.8%). No patient suffered carcinoid crisis during implantation and there was no peri-implant mortality. The median time from implant to death was 2.5 years, with a one-year mortality of 15%.
CHD is a morbid condition and surgical valve intervention carries associated risks, in particular a high requirement for post-operative pacing needs. Our data suggest that CIED implantation can be performed relatively safely. Clinicians must be aware of the relevant carcinoid physiology and take appropriate precautions to mitigate risks.

Copyright © 2021. Published by Elsevier Inc.