Cardiac device complications vary considerably from one hospital to the other



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The risks of complications for patients after implantation of a cardiac device vary depending on where they undergo the procedure.

A study of 174 hospitals in Australia and New Zealand published today in the Annals of Internal Medicine shows that the quality of care received can explain the wide variation in the rate of complications after the insertion of an implantable cardiovascular electronic device (EDIC).

"The study included 81,304 patients who received a new CIED with 65,711 permanent pacemakers and 15,593 implantable cardiac defibrillators," said lead author of the study, Dr. Isuru Ranasinghe, a cardiologist Main, Central Health Local Network.

"Permanent cardiac pacemakers and implantable cardioverter defibrillators are among the most common and expensive devices implanted in hospitals."

"CIED complications are common in 8.2% of patients implanted with new devices with a major complication within 90 days of their operation.The complications experienced by patients vary from 2 to 3 times in hospitals, suggesting that There is variation in the quality of CIED care ".

Last year, nearly 19,000 pacemakers and more than 4,000 defibrillators were implanted in Australia alone. Pacemakers are often suitable for elderly people with bradycardia whose heart beats too slowly. They use electrical impulses to induce the heart to beat at a normal pace. Cardioverter defibrillators track a person's heart rate and, if an abnormal heart rhythm is detected, the device sends an electric shock to restore the heart rate to normal.

"Serious complications can cause significant harm to patients and increase the avoidable health care costs." About 60% of these complications occur after leaving the hospital, so many doctors and hospitals may not be able to be fully aware of the complications experienced by patients, "says Dr. Ranasinghe. .

Associate Professor Anand Ganesan, co-investigator of the study and cardiac electrophysiologist at Flinders Medical Center, says, "What this study shows, in fact, is that we should systematically report complication rates in hospitals to make them fully visible to clinicians, hospitals and the community at large, and we should also invest in proven strategies to reduce them, such as the optimization of procedural techniques, the adoption of better infections and management of anticoagulant drugs along with the procedures. "

Dr. Ranasinghe said, "Encouraging hospitals to participate in quality improvement activities such as checking for complications and maintaining clinical-grade records also helps reduce complications over time."


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More information:
Isuru Ranasinghe et al, Institutional Variation in the Quality of Implantation of Cardiovascular Implantable Electronic Devices, Annals of Internal Medicine (2019). DOI: 10.7326 / M18-2810

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University of Adelaide


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Cardiac device complications vary considerably from one hospital to another (2019, July 30)
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