Abstract | OBJECTIVES: BACKGROUND: Data are lacking on the risk of stroke in patients with PFO and implantable intracardiac devices, either a PPM or an ICD. We investigated whether patients with PFO have increased risk of stroke due to PPM/ICD implantation. METHODS: Between 2001 and 2008, 2,921 consecutive patients with PFO (67.5 ± 16.4 years of age, 52.2% male) were identified from our echocardiography database. These patients were divided into a device group (patients had PPM/ICD implantation for any reason after receiving a diagnosis of PFO) and a no device group (patients did not have PPM or ICD implantation). Patients who had PFO closure during follow-up were excluded. Both groups were matched for baseline characteristics and medications. The incidence of ischemic stroke was assessed in each group after propensity score matching (case:control ratio of 1:1 yielding 231 pairs). All patients completed at least 4 years of follow-up until May 2012. RESULTS: There were 2,690 patients in the n device group (67.3 ± 16.4 years of age, 51.6% male) and 231 patients in the device group (75.4 ± 14.6 years of age, 59.3% male). Six patients (2.6%) in the no device group and 6 (2.6%) in the device group had a stroke during the follow-up period. No difference in the rate of stroke, transient ischemic stroke, or stroke/transient ischemic stroke was observed between the 2 groups. CONCLUSIONS: The risk of stroke in patients with PFO and an implantable intracardiac device is similar to those without an intracardiac device. In patients with PFO, without a history of stroke, device implantation might not be considered a risk factor for future stroke occurrence.
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Authors | Kanhaiya L Poddar, Vijaiganesh Nagarajan, Amar Krishnaswamy, Navkaranbir S Bajaj, Meera Kumari, Hazem Bdair, Dhruv Modi, Shikhar Agarwal, Sachin S Goel, Akhil Parashar, E Murat Tuzcu, Samir R Kapadia |
Journal | JACC. Cardiovascular interventions
(JACC Cardiovasc Interv)
Vol. 7
Issue 11
Pg. 1221-6
(Nov 2014)
ISSN: 1876-7605 [Electronic] United States |
PMID | 25326741
(Publication Type: Journal Article)
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Copyright | Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. |
Topics |
- Aged
- Aged, 80 and over
- Brain Ischemia
(diagnosis, epidemiology)
- Cardiac Pacing, Artificial
(adverse effects)
- Comorbidity
- Databases, Factual
- Defibrillators, Implantable
(adverse effects)
- Electric Countershock
(adverse effects, instrumentation)
- Female
- Foramen Ovale, Patent
(diagnosis, epidemiology)
- Humans
- Incidence
- Male
- Middle Aged
- Ohio
(epidemiology)
- Pacemaker, Artificial
(adverse effects)
- Retrospective Studies
- Risk Assessment
- Risk Factors
- Stroke
(diagnosis, epidemiology)
- Time Factors
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