Cardiac implantable electronic devices in tracheotomized muscular dystrophy patients: Safety and risks.

Details

Serval ID
serval:BIB_D71D2648D329
Type
Article: article from journal or magazin.
Collection
Publications
Title
Cardiac implantable electronic devices in tracheotomized muscular dystrophy patients: Safety and risks.
Journal
International journal of cardiology
Author(s)
Fayssoil A., Lazarus A., Wahbi K., Ogna A., Nardi O., Lofaso F., Clair B., Orlikowski D., Annane D.
ISSN
1874-1754 (Electronic)
ISSN-L
0167-5273
Publication state
Published
Issued date
01/11/2016
Peer-reviewed
Oui
Volume
222
Pages
975-977
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Muscular dystrophies are genetic muscle disorders, in which heart involvement and chronic respiratory impairment affect survival. Cardiac conduction disturbances require implantable cardiac pacemaker. Implantable defibrillators may also be necessary to prevent cardiac sudden death. The safety and risk of cardiac electronic devices' implantation are not known in patients with muscular dystrophy. We aimed to assess the risks related to cardiac implantable electronic devices (CIED) in muscular dystrophy patients ventilated by tracheostomy.
We reviewed all medical charts of neuromuscular patients and identified all CIED implantations of pacemakers (PM) or defibrillators (ICD) in patients ventilated using tracheostomy.
Twelve device implantations were included, performed in 9 patients (5 DMD, 1 Becker muscular dystrophy and 3 DM1). Mean age was 39.9years±13.0. All patients were wheel-chair bound and tracheotomized. Six pacemakers (PM) and 6 cardiac resynchronization (CRT) devices, including 2 defibrillators (CRT-D) were implanted. Following device implantation, two patients had a pneumothorax and one died from severe heart failure after an unsuccessful CRT implant attempt. Follow-up lasted up to 8years (mean 2.6±2.9years), during which one patient presented a PM pocket infection, requiring PM explantation and epicardial reimplantation.
We found a high prevalence of early complications (16.6% pneumothorax) after CIED implantation and an acceptable long-term infectious risk (8.3%). These results highlight the feasibility of CIED implantation in tracheotomized patients with muscular dystrophies and the need for a particular caution in the management of these patients during invasive procedures. ClinicalTrials.gov (identifier: NCT02501083).

Keywords
Implantable cardiac defibrillator, Infection, Muscular dystrophy, Pacemaker, Pneumothorax, Tracheotomy
Pubmed
Web of science
Create date
25/08/2017 10:12
Last modification date
20/08/2019 15:56
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