B-po01-041 trends in non-infectious cardiovascular implantable electronic device complications over three decades: insights from the rochester epidemiology project device registry

Cardiovascular implantable electronic devices (CIEDs) such as permanent pacemakers, implantable cardioverter-defibrillators, and cardiac resynchronization therapy devices alleviate morbidity and mortality in various diseases. There is a paucity of real-world data on CIED complications and trends. Describe trends in non-infectious CIED complications over the past three decades in Olmsted County. The Rochester Epidemiology Project is a medical records linkage system comprising records of over 500,000 residents of Olmsted County from 1966-current. CIED implants between 1988-2015 were determined. Trends in non-infectious complications within 30 days of implant were analyzed. A total of 174 complications were noted in 2163 patients. Lead dislodgement was the most common (3.1%) followed by hematoma (2.4%). Complications went up from 1988 to 2005, then showed a downtrend until 2015, driven by a decline in hematomas in the last decade (p<0.01). Those with complications were noted to have a higher proportion of valvular disease and lower obesity rates. Patient characteristics for specific complications are elucidated in the Figure. Our study describes a real-world trend of CIED complications over three decades. Lead dislodgements and hematomas were the most common complications. Complications have declined over the last decade likely owing to safer practices and a better understanding of anticoagulant management.