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Coronary sinus (CS) dissection is a known complication during CRT-D implantation, but the overall incidence and clinical outcomes have not been extensively studied. We sought to describe predictors of CS dissection and consequent in-hospital adverse events in those with the complication.
We studied 140,991 first-time CRT-D recipients in the ICD Registry™ implanted between January, 2006 and September, 2011. Using hierarchical multivariable logistic regression adjusting for patient, implanting physician, and hospital characteristics, we examined the predictors of CS dissection and its association with other major complications, length of hospital stay, and mortality.
CS dissection occurred in 392 patients (0.28%). After multivariable adjustment, female sex and LBBB were associated with increased odds of CS dissection. Conversely, atrial fibrillation, previous CABG, and higher implanter procedure volume were associated with a lower odds of CS dissection (all p values <0.05). Those with CS dissection had a greater odds of other major complications (cardiac arrest, myocardial infarction, cardiac perforation, pericardial tamponade or infection) and hospital stay >3 days, but not death (Figure).
In a large population of first-time CRT-D recipients, several patient and implanter characteristics predicted CS dissection risk. CS dissection was associated with other major in-hospital complications and prolonged hospitalization, but not death.
Poster Sessions, Expo North
Saturday, March 09, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Heart Failure: Cardiac Resynchronization Therapy
Abstract Category: 17. Heart Failure: Therapy
Presentation Number: 1177-305
- 2013 American College of Cardiology Foundation