Beaumont Cardiologist Develops Tool to Assess Risk of Implantable Cardioverter- Defibrillator Complications
Research published in American Heart Association Circulation Journal
A new risk assessment tool has been developed that can help identify patients at high or low risk for complications after implantable cardioverter-defibrillator procedures. This information can guide physicians in selecting patients for ICD procedures and determining the level of care they require after the procedure.
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| David Haines, M.D., lead researcher |
Led by David Haines, M.D., director of Beaumont’s Heart Rhythm Center, the assessment tool is described in research published in the May issue of the American Heart Association journal Circulation.
Haines, along with researchers from Yale University, evaluated clinical data from 268,701 patients at 1,300 hospitals in the United States between January 2006 and June 2008. They used 10 common pre-procedure variables to gauge each patient’s potential for complications after defibrillator implantation.
“As a result of this research, we should be able to risk-stratify patients better based upon pre-procedural variables,” says Dr. Haines. “This may help us to determine the best candidates for same-day hospital discharge versus those who need hospital admission after an ICD procedure.”
A simple risk score of 10 readily available variables successfully identified patients at high or low risk of complication. The variables include: age over 70 years; female sex; atrial fibrillation; prior valve surgery; chronic lung disease; blood urea nitrogen greater than 30; device reimplantation for reasons other than battery change; the type of ICD device; non-elective ICD; and the patient’s New York Heart Association heart-failure classification.
Patients with a score of 19 points or greater (3.9 percent of the study population) had a high risk of complications, requiring high intensity care following their implant procedure. Patients with a score of five points or less (8.4 percent of the study population) had a low, 0.6 percent risk of complications. These low-risk patients should be able to go home sooner, possibly even the same day of their procedure.
Use of the risk assessment tool may lead to better patient outcomes at lower cost for hospitals, insurers and patients, while increasing patient convenience and satisfaction.
See the abstract of the research project at http://circ.ahajournals.org/cgi/content/abstract/CIRCULATIONAHA.110.959676v1.
Beaumont is Michigan’s, and one of the nation’s, most experienced providers of heart care, ranking 28th on the 2010 U.S. News & World Report list of “America’s Best Hospitals” for heart and heart surgery. The Beaumont Heart and Vascular Center is a comprehensive, state-of-the-art facility that’s dedicated to the prevention, diagnosis and treatment of heart problems. Beaumont’s Ernst Cardiovascular Center includes six specialty clinics offering advanced and minimally invasive treatments for heart valve disease, atrial fibrillation, congestive heart failure, aortic aneurysm and dissection, plus preventive screening for adults and high school students. Beaumont’s Ministrelli Women’s Heart Center is the first in Michigan devoted exclusively to the prevention, diagnosis, and research of heart disease in women.
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