{
  "abstract": "Introduction This audit evaluates complication and re-intervention rates following Cardiac Rhythm Management (CRM) device implantation at Hull University Teaching Hospitals NHS Trust (HUTH), with follow-up over 12 months (July 2023 to July 2024). The audit aligns with British Heart Rhythm Society (BHRS) standards and National Institute for Cardiovascular Outcomes Research (NICOR) reporting requirements, supporting clinical governance and national benchmarking.Methods A retrospective review was performed of all CRM device procedures undertaken at HUTH during the audit period. Complications were assessed at discharge and again at 12 months post-implantation in accordance with BHRS guidance. Patients were tracked using NHS numbers, with outcomes identified through review of discharge summaries, chest radiographs, GP records, and NICOR submissions. Complications assessed included pneumothorax requiring intervention or prolonged admission, device-related infection, haematoma requiring intervention, pericardial effusion requiring intervention, lead displacement, and any re-intervention within 12 months.Results A total of 581 CRM procedures were reviewed, including elective and acute cases. Nineteen re-interventions occurred within 12 months, giving an overall re-intervention rate of 3.2% ( table 1). These comprised four failed left ventricular (LV) leads (7.5% of all LV leads), two wound revisions due to infection (0.3% of all implants), and thirteen lead displacements (2.2% of all implants) (tables 2 and 3). The local 12-month re-intervention rate was lower than the national median of 5.6% reported by NICOR. HUTH serves a population of approximately 600,000. The national target implantation rate for implantable cardioverter-defibrillators (ICDs) is 110 per million population (equivalent to 66 per million for the local population), which has not yet been achieved locally, indicating scope for targeted service development and pathway optimisation.Conclusions Complication and re-intervention rates following CRM device implantation at HUTH were lower than national median NICOR figures, demonstrating favourable procedural outcomes and adherence to BHRS standards. Continued surveillance, accurate complication reporting, and consistent NICOR submission remain essential to support quality assurance, benchmarking, and ongoing service improvement.Procedural Summary Tables Abstract 212 Table 1Procedural complications in relation to total procedures performed (n = 581)ComplicationN%Reintervention193.27Displaced lead132.24Hematoma61.03Pneumothorax30.52Wound revision20.34Infection20.34RA lead failure10.17Device erosion10.17Pericardial effusion10.17Abstract 212 Table 2Procedure types performed (n = 581)Procedure Typen%New implant37063.7Generator replacement16027.5Temp/Perm implant162.8Upgrade to CRT101.7Generator replacement & lead intervention101.7Lead intervention50.9Upgrade to CRT & lead intervention20.3System explant20.3Other (generator replacement + washout + reburial; generator replacement; system explant + new implant; system explant + temp/perm implant)61.0Abstract 212 Table 3Device types implanted (n = 386)Device Typen%PPM27370.7CRT-P359.1ICD328.3CRT-D184.7Temp/Perm PPM164.1SICD123.1",
  "authors": [
    {
      "affiliations": [
        "Cardiology Department, Castle Hill Hospital, Hull University Teaching Hospitals NHS Trust (HUTH), UK"
      ],
      "name": "Shady Hanna"
    },
    {
      "affiliations": [
        "Cardiology Department, Castle Hill Hospital, Hull University Teaching Hospitals NHS Trust (HUTH), UK"
      ],
      "name": "Chelsea Muszynski"
    },
    {
      "affiliations": [
        "Cardiology Department, Castle Hill Hospital, Hull University Teaching Hospitals NHS Trust (HUTH), UK"
      ],
      "name": "Amanda Fordham"
    },
    {
      "affiliations": [
        "Cardiology Department, Castle Hill Hospital, Hull University Teaching Hospitals NHS Trust (HUTH), UK"
      ],
      "name": "Rommerico Floresca"
    },
    {
      "affiliations": [
        "Cardiology Department, Castle Hill Hospital, Hull University Teaching Hospitals NHS Trust (HUTH), UK"
      ],
      "name": "Renjith Antony"
    }
  ],
  "title": "212 Review of complication rates in cardiac rhythm management devices at Hull University Teaching Hospitals (July 2023 to July 2024) with follow-up over 12 months",
  "uid": "786fb034-19b4-517f-81c5-576d83066115"
}