Defibrillator Implantation May Be Riskier for Underweight Patients

TUESDAY, March 27 (HealthDay News) — Patients who are small or
underweight are at greater risk for complications during the placement of
an implantable cardioverter-defibrillator, a new study indicates.

Implantable cardioverter-defibrillators (ICDs) are devices that shock
the heart into beating again if it stops or begins to beat in an irregular
manner.

The researchers also found that the most common complications seen
among smaller patients were collapsed lungs and hematomas, or blood
pooling in the area where the small, battery-powered device is
implanted.

“If you are having a defibrillator placed, being underweight may put
you at risk for adverse events from the implantation procedure,” lead
investigator Dr. Jonathan Hsu, a fellow in cardiac electrophysiology at
the University of California, San Francisco, said in a news release from
the American College of Cardiology.

“Having a lower body mass index may put you at higher risk of having
complications, staying in the hospital for longer and even dying from the
procedure,” Hsu added. Body mass index, or BMI, is a measurement of body
fat based on height and weight.

In conducting the study, the researchers examined more than 83,000
cases to determine how body size influences the success of ICD
implantation. They found that patients with a low BMI had longer hospital
stays, more complications and greater risk for death during or right after
the procedure than those who were normal weight or overweight.

Some reasons smaller patients may be at greater risk might include
contributing factors such as frailty, malnutrition and coexisting
conditions, such as cancer, the study authors theorized. The findings
could help doctors better understand patients’ risks and help prevent
complications from ICD implantation, they said.

“Body size is something that’s easily measurable,” Hsu said in the news
release. “Talking with patients about the benefits and risks is an
important part of what we do, and implanters can use this information in
counseling patients who may be at higher risk.”

Hsu said doctors could also access the chest cavity differently to
reduce the risk of collapsed lungs, revise their strategy for
anticoagulation medications to reduce the risk of bleeding or use
compression bandages to prevent blood pooling in the implantation
area.

The study authors noted that their findings could apply to other heart
procedures as well.

“Perhaps this pattern isn’t just in cardiovascular patients or ICD
implant patients,” said Hsu. “It’s possible that we haven’t been looking
at underweight patients and their risks closely enough because we’ve been
focusing so much attention on obese patients.”

The study was presented Sunday at the American College of Cardiology’s
annual meeting in Chicago. Any research presented at medical meetings
should be viewed as preliminary until it is published in a peer-reviewed
medical journal.

More information

The U.S. National Heart, Lung, and Blood Institute provides more
information on ICDs.

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