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Tytuł:
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Abstract 13068: Use of Cardiac Implantable Electronic Devices in Carcinoid Heart Disease
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Autorzy:
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Ward, Robert
Luis, Sushil A
Shabtaie, Samuel
Pellikka, Patricia A
Connolly, Heidi M
Miranda, William
Schaff, Hartzell
Shen, Win-Kuang
Cha, Yong-mei
Asirvatham, Samuel
Deshmukh, Abhishek
Desimone, Christopher V
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Źródło:
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Circulation (Ovid); November 2021, Vol. 144 Issue: Supplement 1 pA13068-A13068, 1p
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Introduction:Carcinoid heart disease (CHD) is a rare sequelae of hormonally active neuroendocrine tumors that often requires cardiac surgical intervention. Little is reported on cardiac implantable electronic device (CIED) implantation in the CHD patient population.Hypothesis:We sought to establish the safety and efficacy of CIED implantation in patients with CHD.Methods:We retrospectively reviewed patients with a diagnosis of CHD who underwent CIED implantation at our institution (Mayo Clinic) and evaluated indications for implant, perioperative complications, and mortality.Results:A total of 27 patients with a cumulative follow up of 75 patient-years were identified during the study period. The most common indication for device implant was high grade atrioventricular block (n=18, 66.7%). 14 (51.8%) had baseline conduction disease and 26 (96.2%) underwent cardiac surgery prior to CIED implant. The majority of devices implanted were dual chamber permanent pacemakers (PPM) (n=17, 63.0%), while other devices included single chamber PPM, epicardial PPM, chronic resynchronization devices, and intracardiac defibrillators. Peri-operative complication occurred in 6 patients (22.2%), with 2 patients requiring ICU level care. No patient suffered carcinoid crisis during implantation and there was no peri-implant mortality. Long term, 3 patients required device extraction: 1 for infection, 1 for lead related pain, and 1 for generator migration. The median time to death from implant was 2.5 years, with one-year mortality at 15%.Conclusions:In this unique cohort of patients with CHD, CIED can be performed safely. CIED most often occurred in the post cardiac surgical period and carcinoid crisis was uncommon.