Key result
The extent of CIED displacement toward the shoulder in the supine position was an independent predictor of shoulder impairment (OR 1.502; 95% CI 1.186-1.852; p=0.01).
Why the study?
Device-related shoulder impairment is common after CIED placement, but the relationship between device displacement toward the shoulder in the supine position and ipsilateral impairment had not been examined.
Does the extent of CIED displacement toward the shoulder in the supine position predict shoulder impairment in CIED recipients?
Cross-Sectional (n=142)
Does the extent of CIED displacement toward the shoulder in the supine position predict shoulder impairment in CIED recipients?
Odds Ratio: 1.502 (95% CI 1.186–1.852)
p-value: p=.01
Excessive displacement of CIEDs toward the shoulder in the supine position is an independent predictor of shoulder impairment, particularly in obese females with defibrillators.
May support position assessment in symptomatic CIED patients; leaves open whether interventions reduce impairment.
BACKGROUND: Device-related shoulder impairment is a common complication in cardiac implantable electronic device (CIED) recipients. This study examined the relationship between the extent of device displacement toward the shoulder while in the supine position and ipsilateral shoulder impairment. METHODS: This cross-sectional study included 142 consecutive patients with CIEDs. The effects of the extent of device displacement on functional limitations, muscle strength, pain-disability, and quality of life were evaluated. Range of motion (ROM), grip strength (GS), the Shoulder Pain and Disability Index (SPADI), and the 36-item Short-Form (SF-36) Health Survey were used. RESULTS: The mean device displacement was greater in patients with than without device-related shoulder impairment (51 ± 19 vs. 38 ± 15 mm; p < .001). Female gender (p = .046), high body mass index (p = .008), and defibrillator implantation (p = .004) were significantly more frequent in patients with than without impairment. Patients with excessive device displacement had significantly higher ROM limitation rates (p = .003) and SPADI scores (p = .02) and significantly lower GS (p = .04) and SF-36 scores (p = .032). Defibrillator implantation (OR: 2.569, 95% CI: 1.216-4.681; p = .03) and the extent of device displacement (OR: 1.502, 95% CI: 1.186-1.852; p = .01) were independent predictors of shoulder impairment. CONCLUSIONS: Excessive displacement of the device toward the shoulder while in the supine position causes shoulder impairment by contacting more muscle fibers. Obese female patients with defibrillators have the highest risk.
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Coşgun et al. (2022) conducted a cross-sectional in Cardiac implantable electronic device (CIED) recipients (n=142). Extent of device displacement toward the shoulder vs. Less device displacement was evaluated on Shoulder impairment (OR 1.502, 95% CI 1.186-1.852, p=.01). The extent of CIED displacement toward the shoulder in the supine position was an independent predictor of shoulder impairment (OR 1.502; 95% CI 1.186-1.852; p=0.01).
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