Institutional Variation in Quality of Cardiovascular Implantable Electronic Device Implantation
Authors: Mehrdad Emami, Christopher X. Wong, Samuel Tu, Prashanthan Sanders, Glenn D. Young
Journal: Annals of Internal Medicine (2020)

Letters21 January 2020Institutional Variation in Quality of Cardiovascular Implantable Electronic Device ImplantationMehrdad Emami, MD, Christopher X. Wong, MBBS, PhD, Samuel Tu, Prashanthan Sanders, MBBS, PhD, and Glenn D. Young, MBBSMehrdad Emami, MDCentre for Heart Rhythm Disorders, University of Adelaide, and Royal Adelaide Hospital, Adelaide, South Australia, Australia (M.E., C.X.W., S.T., P.S., G.D.Y.)Search for more papers by this author, Christopher X. Wong, MBBS, PhDCentre for Heart Rhythm Disorders, University of Adelaide, and Royal Adelaide Hospital, Adelaide, South Australia, Australia (M.E., C.X.W., S.T., P.S., G.D.Y.)Search for more papers by this author, Samuel TuCentre for Heart Rhythm Disorders, University of Adelaide, and Royal Adelaide Hospital, Adelaide, South Australia, Australia (M.E., C.X.W., S.T., P.S., G.D.Y.)Search for more papers by this author, Prashanthan Sanders, MBBS, PhDCentre for Heart Rhythm Disorders, University of Adelaide, and Royal Adelaide Hospital, Adelaide, South Australia, Australia (M.E., C.X.W., S.T., P.S., G.D.Y.)Search for more papers by this author, and Glenn D. Young, MBBSCentre for Heart Rhythm Disorders, University of Adelaide, and Royal Adelaide Hospital, Adelaide, South Australia, Australia (M.E., C.X.W., S.T., P.S., G.D.Y.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L19-0708 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Ranasinghe and colleagues (1) describe major device-related complications after cardiac implantable electronic device (CIED) implantation. Using national coding data, they included all 81 304 patients who received new implants in Australia and New Zealand between 2010 and 2015. They reported that, on average, 8.2% had major device-related complications. For hospitals with high volume (that is, those that implanted ≥25 CIEDs over the 5 years), estimated risk-standardized complication rates ranged from 5.3% to 14.3%. We believe that these values are overestimated.First, the use of administrative coding data only without clinical adjudication does not consider whether a postprocedural issue ...References1. Ranasinghe I, Labrosciano C, Horton D, et al. Institutional variation in quality of cardiovascular implantable electronic device implantation. A cohort study. Ann Intern Med. 2019;171:309-17. [PMID: 31357210]. doi:10.7326/M18-2810 LinkGoogle Scholar2. Silverman E, Skinner J. Medicare upcoding and hospital ownership. J Health Econ. 2004;23:369-89. [PMID: 15019762] CrossrefMedlineGoogle Scholar3. Kirkfeldt RE, Johansen JB, Nohr EA, et al. Complications after cardiac implantable electronic device implantations: an analysis of a complete, nationwide cohort in Denmark. Eur Heart J. 2014;35:1186-94. [PMID: 24347317] doi:10.1093/eurheartj/eht511 CrossrefMedlineGoogle Scholar4. Lee DS, Krahn AD, Healey JS, et al; Investigators of the Ontario ICD Database. Evaluation of early complications related to de novo cardioverter defibrillator implantation insights from the Ontario ICD database. J Am Coll Cardiol. 2010;55:774-82. [PMID: 20170816] doi:10.1016/j.jacc.2009.11.029 CrossrefMedlineGoogle Scholar5. Freeman JV, Wang Y, Curtis JP, et al. Physician procedure volume and complications of cardioverter-defibrillator implantation. Circulation. 2012;125:57-64. [PMID: 22095828] doi:10.1161/CIRCULATIONAHA.111.046995 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Centre for Heart Rhythm Disorders, University of Adelaide, and Royal Adelaide Hospital, Adelaide, South Australia, Australia (M.E., C.X.W., S.T., P.S., G.D.Y.)Financial Support: Dr. Emami is supported by a postgraduate scholarship from the University of Adelaide. Dr. Wong is supported by a fellowship from The Hospital Research Foundation. Dr. Sanders is supported by a practitioner fellowship from the National Health and Medical Research Council and National Heart Foundation of Australia.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L19-0708. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoInstitutional Variation in Quality of Cardiovascular Implantable Electronic Device Implantation Isuru Ranasinghe , Clementine Labrosciano , Dennis Horton , Anand Ganesan , Jeptha P. Curtis , Harlan M. Krumholz , Andrew McGavigan , Sadia Hossain , Tracy Air , and Saranya Hariharaputhiran Institutional Variation in Quality of Cardiovascular Implantable Electronic Device Implantation Isuru Ranasinghe , Sadia Hossain , Anand Ganesan , Harlan M. Krumholz , and Andrew McGavigan Metrics 21 January 2020Volume 172, Issue 2Page: 166KeywordsAdverse eventsCardiovascular implantable electronic devicesDeath ratesDisclosureElderlyFellowshipsHeartInformation storage and retrievalMotivation ePublished: 21 January 2020 Issue Published: 21 January 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...