Journal of arrhythmia · 2023
Impact of raising the upper extremity siding cardiac implantable electrical devices on postoperative safety.
СтатьяНазвание и аннотация: Перевод в очереди
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Takeda Tomonori, Tsubaki Atsuhiro, Ikeda Yoshifumi, Kato Ritsushi, Kojima Sho, Makita Shigeru
Аннотация
BACKGROUND: The upper extremity siding cardiac implantable electrical device tends to have a limited range of motion during the perioperative period; however, the underlying reason lacks scientific evidence. This study aimed to investigate the safety of the two methods (stepwise or early) of postoperative early upper extremity rehabilitation.
METHODS: We retrospectively investigated 650 consecutive patients with a new implantable pacemaker (PM), implantable cardioverter-defibrillator (ICD), cardiac resynchronization therapy (CRT), or generator exchange between March 2017 and December 2020.The limitation program was conducted from March 2017 to March 2018. The intervention program started as a stepwise protocol in April 2018 and was switched to an early protocol in December 2019.
RESULTS: This study analyzed 591 patients, excluding 59 who met the exclusion criteria. The mean age was 76.0 (69.0-82.0) years; 412 (69.7%) patients had a PM, 79 (13.4%) had an ICD, and 100 (16.9%) utilized CRT. There were 155 patients in the limitation protocol, 251 in the stepwise protocol, and 185 patients in the early protocol groups. Postoperative complications occurred in 53 (9.0%) patients. There was no significant difference in the incidence of all complications between the three groups (16 patients [10.3%] vs. 26 patients [10.4%] vs. 11 patients [5.9%]). Shoulder exercise-related complications were defined as hematoma (p = .94), lead dislodgement (p = .16), and increased pacing threshold (p = .23). General complications included wound infection (p = .51), pneumothorax (p = .27), tamponade (p = .07), and deep venous thrombosis (p = .26).
CONCLUSION: Raising of the upper extremity siding cardiac implantable electrical devices above the head did not compromise postoperative safety.
METHODS: We retrospectively investigated 650 consecutive patients with a new implantable pacemaker (PM), implantable cardioverter-defibrillator (ICD), cardiac resynchronization therapy (CRT), or generator exchange between March 2017 and December 2020.The limitation program was conducted from March 2017 to March 2018. The intervention program started as a stepwise protocol in April 2018 and was switched to an early protocol in December 2019.
RESULTS: This study analyzed 591 patients, excluding 59 who met the exclusion criteria. The mean age was 76.0 (69.0-82.0) years; 412 (69.7%) patients had a PM, 79 (13.4%) had an ICD, and 100 (16.9%) utilized CRT. There were 155 patients in the limitation protocol, 251 in the stepwise protocol, and 185 patients in the early protocol groups. Postoperative complications occurred in 53 (9.0%) patients. There was no significant difference in the incidence of all complications between the three groups (16 patients [10.3%] vs. 26 patients [10.4%] vs. 11 patients [5.9%]). Shoulder exercise-related complications were defined as hematoma (p = .94), lead dislodgement (p = .16), and increased pacing threshold (p = .23). General complications included wound infection (p = .51), pneumothorax (p = .27), tamponade (p = .07), and deep venous thrombosis (p = .26).
CONCLUSION: Raising of the upper extremity siding cardiac implantable electrical devices above the head did not compromise postoperative safety.