Advantages of Intra-cardiac Polymer Coated Electrodes Leads in Patients with Diabetes Mellitus and Cardiovascular Implantable Electronic Devices

Silvius Alexandru Pescariu,Gheorghe Nicusor Pop,Bogdan Andor,Sorin Pescariu,Romulus Timar,Mariana Tudoran,Cristina Tudoran

doi:10.37358/mp.20.2.5349

Abstract

Diabetes mellitus (DM) and cardiovascular diseases (CVD) represent worldwide, major health problems. Frequently, diabetic patients may require therapy with implantable intra-cardiac electronic devices. In this article, we analysed the complications related to the presence of polymer-coated electrodes leads occurred among 351 patients, carriers of implantable electronic intra-cardiac devices: permanent pacemakers (PPM), cardiac resynchronisation therapy (CRT) or implantable cardioverter-defibrillators (ICD). Of all these patients, 99 (28.20%) had type 2 DM (p=0.022), double than the prevalence of DM in the general population (11%). Only two patients with PPM and DM had fractures of electrodes leads and one was diagnosed with right heart infective endocarditis, but no non-diabetic patient developed any complications related to the presence of polymer coated electrodes leads.

Highlights

Type 2 diabetes mellitus (DM) represents a major risk factor for ischemic heart disease (IHD), dilated cardiomyopathy (DCM) and chronic heart failure (CHF) being associated with increased cardiovascular morbidity and mortality [1]
By using the International classification and statistic of diseases (ICD-10-AM) - code Z95, from hospital’s database, of all 351 subjects admitted for the implantation of a cardiac implantable electronic devices (CIED) for rhythm control or for resynchronization therapy or who were already carriers of a dysfunctional device or who required hospitalization for other reasons, we identified 19 patients with issues related to the presence of CIED
99 patients were diagnosed with type 2 DM, in opposition to 252 subjects without diabetes, a consistent higher percent than the general prevalence of type 2 DM reported for our country (11%) in Predatorr study

Summary

Introduction

Type 2 diabetes mellitus (DM) represents a major risk factor for ischemic heart disease (IHD), dilated cardiomyopathy (DCM) and chronic heart failure (CHF) being associated with increased cardiovascular morbidity and mortality [1]. In this article we debate over the complications associated to transvenous implantation of polymer coated electrodes leads in a group of 351 patients admitted during 01 January 2018 – 31 December 2019 in a tertiary cardiovascular center for the implantation of an electronic intra-cardiac device or being carriers of a dysfunctional device or required hospitalization for another medical reason. Their medical records were analyzed in order to evidence any complications associated to the presence of intra-cardiac. Polymer coated electrodes leads as well as for the type of device implanted, the main indication for this therapy, the concomitance of type 2DM, and their outcomes

Materials and methods

Results and discussions

Conclusions