History of carpal tunnel surgery ups complication risk after pacemaker implantation

A prior history of surgery for carpal tunnel syndrome (CTS) appears to aggravate the future risk of hospitalization, new-onset heart failure, and cardiac amyloidosis after pacemaker implantation, a recent study has found.

Drawing from Danish nationwide registries, researchers examined 57,315 patients who had received pacemaker implants. All were ≥50 years of age at the time of placement and 2.2 percent (n=1,266) had had previous CTS surgery. Outcomes were adverse cardiovascular events in the 5 years after implantation, assessed according to surgical history.

The cumulative 5-year mortality rate was 44.6 percent in CTS patients, significantly higher than the corresponding 40.2-percent rate in those without a history of CTS (p=0.04). Crude Cox analysis found that prior CTS surgery significantly aggravated 5-year death risk by 11 percent (hazard ratio [HR], 1.11, 95 percent confidence interval [CI], 1.01–1.22; p=0.04), but this association was attenuated after adjusting for age (adjusted HR, 1.02, 95 percent CI, 0.93–1.13; p=0.65).

In addition, having undergone CTS surgery likewise led to a 32-percent increase in the risk of heart failure hospitalization (adjusted HR, 1.32, 95 percent CI, 1.11–1.57; p=0.002) and of being diagnosed with amyloidosis (adjusted HR, 7.72, 95 percent CI, 2.67–20.10; p<0.001) after pacemaker implantation.

“These results suggest that screening for cardiac amyloidosis may have a place in patients with previous CTS undergoing pacemaker implantation,” the researchers said.