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.