Association of body mass index with complications in cardiac implantation electronic devices: A retrospective single-center cohort study
Salman Hassan, F.N.U. Anam, Muhammad Ayoob Memon, Maneesh Makhija, Robish Kishore, Haresh Kumar, Ritesh Kumar, Tanveer Ishaque, Jahanzeb Malik, Ali Najam, Waheed Akhtar, Muhammad Awais, Abida Perveen
Cardiac implantable electronic devices (CIEDs) are increasingly used for managing arrhythmias and advanced heart failure, but implantation procedures carry risks of bleeding, infection, and mechanical complications. Patient-related factors such as obesity and comorbidities, alongside perioperative anticoagulation, may influence outcomes, yet evidence from South Asian populations is limited. We conducted a single-center observational study of 1925 patients who underwent CIED procedures between January 2010 and October 2025 at a tertiary heart center in Pakistan. Patients were categorized by body mass index (BMI) (non-obese, overweight, obese). Anticoagulation and antiplatelet management followed standardized protocols. The primary endpoint was a composite of clinically significant hematoma, pneumothorax, pericardial effusion/tamponade, and device-related infection. Secondary endpoints included each complication separately. Logistic regression was used to identify predictors of adverse events. The mean age of the cohort was 62.3 ± 12.5 years, with 59.9% male. The composite primary endpoint occurred in 70 patients (3.6%), with significantly higher rates in obese individuals (10.4%) compared with overweight (4.3%) and non-obese patients (3.0%,