Persistent pocket-site pain after cardiac implantable electronic device implantation: a prospective observational study of prevalence, neuropathic characteristics, and quality of life.
5 affiliations
- 1Department of Anesthesiology and Reanimation, Istanbul University-Cerrahpasa, Institute of Cardiology, Haseki Caddesi No: 32, Fatih, İstanbul, 34096, Türkiye. [email protected].
- 2Department of Anesthesiology and Reanimation, Istanbul University-Cerrahpasa, Institute of Cardiology, Haseki Caddesi No: 32, Fatih, İstanbul, 34096, Türkiye.
- 3Department of Cardiology, Istanbul University-Cerrahpasa, Institute of Cardiology, Haseki Caddesi No: 32, Fatih, İstanbul, 34096, Türkiye.
- 4Department of Biostatistics, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, İstanbul Üniversitesi-Cerrahpaşa, Avcılar Yerleşkesi, Mühendislik Fakültesi, A Blok, Makine Mühendisliği Bölümü, Kat: 6, Oda No: MF7-617, Avcılar, 34320, Istanbul, Türkiye.
- 5Department of Anesthesiology, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Cerrahpaşa, Koca Mustafapaşa Cd. No: 53, Fatih, İstanbul, 34098, Türkiye.
Abstract
Background
Although transvenous cardiac implantable electronic device (CIED) implantation is generally considered a minor procedure, long-lasting pocket-site pain may represent an underrecognized clinical problem. This study aimed to evaluate the prevalence, characteristics, and clinical impact of persistent pain after CIED implantation.Methods
This prospective observational study included patients who underwent first-time CIED implantation and attended routine outpatient follow-up visits. Pain intensity was assessed using the Visual Analog Scale (VAS), and neuropathic pain characteristics were evaluated using the Douleur Neuropathique 4 Questions (DN-4) questionnaire. Health-related quality of life was assessed using the Short Form-12 (SF-12). Demographic and clinical data were also recorded.Results
A total of 102 patients were included in the analysis. Persistent implantation-site pain (VAS ≥ 4) was reported by 22.5% of patients. Neuropathic pain characteristics (DN-4 ≥ 4) were identified in 26.5% of patients. A moderate positive correlation was observed between VAS and DN-4 scores (ρ = 0.473, p < 0.001). However, the association between VAS ≥ 4 and DN-4 ≥ 4 was not statistically significant and had a small effect size (p = 0.118; φ = 0.15). Pain intensity was moderately negatively correlated with the SF-12 physical component score, indicating reduced physical quality of life with increasing pain severity, while mental quality of life was not significantly affected.Conclusions
Persistent pocket-site pain after CIED implantation affected a clinically meaningful proportion of patients despite generally low overall pain scores. Higher DN-4 scores were associated with poorer physical and mental quality of life and may provide additional clinical information in selected patients. However, because the categorical association between VAS-defined persistent pain and DN-4 positivity was not statistically significant, these findings should be interpreted cautiously and confirmed in larger prospective studies.
Related
- Longitudinal Changes in Anxiety and Depression Following First Implantable Cardioverter-Defibrillator Implantation: A Prospective Observational Study
- TricValve System Implantation in Patients With Cardiac Implantable Electronic Devices: A Multicentre Observational Study
- Nutritional anthropometric indicators predict achievable pocket depth in totally implantable venous access port implantation: a prospective study with 3D-printed measurement device
- Three-Month Ocular Surface and Dry-Eye Outcomes After Implantable Collamer Lens (ICL) Implantation versus Small-Incision Lenticule Extraction (SMILE): A Prospective Non-Randomized Comparative Cohort Study
- Ultrasound-guided peripheral regional anesthesia vs local infiltration anesthesia for cardiac device implantation: A propensity score–matched prospective observational cohort study
BibTeX
@article{altun2026persistent,
title = {{Persistent pocket-site pain after cardiac implantable electronic device implantation: a prospective observational study of prevalence, neuropathic characteristics, and quality of life.}},
author = {Gozde Altun and Ayla Esin and Yasemin Ozsahin and Sukru Arslan and Sahra Asena Balcioglu and Baris Sandal and Kerem Erkalp and Ziya Salihoglu},
journal = {BMC anesthesiology},
year = {2026},
month = aug,
doi = {10.1186/s12871-026-04138-7},
url = {https://europepmc.org/article/MED/42907975},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Persistent pocket-site pain after cardiac implantable electronic device implantation: a prospective observational study of prevalence, neuropathic characteristics, and quality of life.
AU - Gozde Altun
AU - Ayla Esin
AU - Yasemin Ozsahin
AU - Sukru Arslan
AU - Sahra Asena Balcioglu
AU - Baris Sandal
AU - Kerem Erkalp
AU - Ziya Salihoglu
PY - 2026
DA - 2026/08/01
JO - BMC anesthesiology
DO - 10.1186/s12871-026-04138-7
UR - https://europepmc.org/article/MED/42907975
AB - Background Although transvenous cardiac implantable electronic device (CIED) implantation is generally considered a minor procedure, long-lasting pocket-site pain may represent an underrecognized clinical problem. This study aimed to evaluate the prevalence, characteristics, and clinical impact of persistent pain after CIED implantation.Methods This prospective observational study included patients who underwent first-time CIED implantation and attended routine outpatient follow-up visits. Pain intensity was assessed using the Visual Analog Scale (VAS), and neuropathic pain characteristics were evaluated using the Douleur Neuropathique 4 Questions (DN-4) questionnaire. Health-related quality of life was assessed using the Short Form-12 (SF-12). Demographic and clinical data were also recorded.Results A total of 102 patients were included in the analysis. Persistent implantation-site pain (VAS ≥ 4) was reported by 22.5% of patients. Neuropathic pain characteristics (DN-4 ≥ 4) were identified in 26.5% of patients. A moderate positive correlation was observed between VAS and DN-4 scores (ρ = 0.473, p < 0.001). However, the association between VAS ≥ 4 and DN-4 ≥ 4 was not statistically significant and had a small effect size (p = 0.118; φ = 0.15). Pain intensity was moderately negatively correlated with the SF-12 physical component score, indicating reduced physical quality of life with increasing pain severity, while mental quality of life was not significantly affected.Conclusions Persistent pocket-site pain after CIED implantation affected a clinically meaningful proportion of patients despite generally low overall pain scores. Higher DN-4 scores were associated with poorer physical and mental quality of life and may provide additional clinical information in selected patients. However, because the categorical association between VAS-defined persistent pain and DN-4 positivity was not statistically significant, these findings should be interpreted cautiously and confirmed in larger prospective studies.
SN - 1471-2253
ER -