PO-05-011 IMMUNOSUPPRESSIVE THERAPY WAS ASSOCIATED WITH LEAD DISLODGEMENT AFTER CARDIAC IMPLANTABLE ELECTRONIC DEVICE IMPLANTATION

Abstract

Lead dislodgement is one of the severe complications in cardiac implantable electronic device (CIED) implantation. After CIED implantation, adhesions are formed between leads and tissues by inflammation, and as a result, leads are fixed in vessels. In patients with immunosuppressive therapy, such as steroids or immunosuppressant usage, adhesion is inhibited by anti-inflammatory effects. However, no studies have investigated the association between lead dislodgement and immunosuppressive therapy. We hypothesized that lead dislodgement more frequently occurs in patients with immunosuppressive therapy than those without. The purpose of this study was to investigate the association between lead dislodgement and immunosuppressive therapy. In total, 632 consecutive patients who underwent initial CIED implantation or lead addition (age, 76 ± 11 years; male, 365 [58%], high voltage device, 106 [17%], lead addition, 18 [3%]) were retrospectively enrolled. Lead placement was guided by fluoroscopy, and active fixation leads were used in all patients. Chest tape were removed at 1 week after the procedure. Lead dislodgement was defined as a change in the lead position requiring reoperation. As immunosuppressive therapy, 14 (2%) patients used steroids regularly, and 7 (1.1%) used immunosuppressant. Lead dislodgement occurred in 9 (1.4%) patients. Lead dislodgement more frequently occurred in patients with steroids usage than those without (7 (1%) versus 2 (14%), p<0.001). Similarly, lead dislodgement more frequently occurred in patients with immunosuppressant usage than those without (7 (1%) vs 2 (28%), p<0.001). In patients with CIED implantation or lead addition, lead dislodgement more frequently occurred in patients with steroids usage or immunosuppressant usage than those without.