{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T11:32:45Z","timestamp":1784892765466,"version":"3.55.0"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"20","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2021,11,16]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Prescription opioids are a major contributor to the ongoing epidemic of persistent opioid use (POU). The incidence of POU among opioid-na\u00efve patients after cardiac implantable electronic device (CIED) procedures is unknown.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>This retrospective cohort study used data from a national administrative claims database from 2004 to 2018 of patients undergoing CIED procedures. Adult patients were included if they were opioid-na\u00efve during the 180-day period before the procedure and did not undergo another procedure with anesthesia in the next 180 days. POU was defined by filling an additional opioid prescription &gt;30 days after the CIED procedure.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              Of the 143 400 patients who met the inclusion criteria, 15 316 (11%) filled an opioid prescription within 14 days of surgery. Among these patients, POU occurred in 1901 (12.4%) patients 30 to 180 days after surgery. The likelihood of developing POU was increased for patients who had a history of drug abuse (odds ratio, 1.52;\n              <jats:italic>P<\/jats:italic>\n              =0.005), preoperative muscle relaxant (odds ratio, 1.52;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) or benzodiazepine (odds ratio, 1.23;\n              <jats:italic>P<\/jats:italic>\n              =0.001) use, or opioid use in the previous 5 years (OR, 1.76;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001). POU did not differ after subcutaneous implantable cardioverter defibrillator or other CIED procedures (11.1 versus 12.4%;\n              <jats:italic>P<\/jats:italic>\n              =0.5). In a sensitivity analysis excluding high-risk patients who were discharged to a facility or who had a history of drug abuse or previous opioid, benzodiazepine, or muscle relaxant use, 8.9% of the remaining cohort had POU. Patients prescribed &gt;135 mg of oral morphine equivalents had a significantly increased risk of POU.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>POU is common after CIED procedures, and 12% of patients continued to use opioids &gt;30 days after surgery. Higher initially prescribed oral morphine equivalent doses were associated with developing POU.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circulationaha.121.055524","type":"journal-article","created":{"date-parts":[[2021,11,15]],"date-time":"2021-11-15T19:00:20Z","timestamp":1637002820000},"page":"1590-1597","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["Persistent Opioid Use After Cardiac Implantable Electronic Device Procedures"],"prefix":"10.1161","volume":"144","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3155-2006","authenticated-orcid":true,"given":"Timothy M.","family":"Markman","sequence":"first","affiliation":[{"name":"Cardiovascular Division (T.M.M., G.S.G., M.C.H., J.S.A., P.S., R.D.S., G.E.S., R.D., S.N., S.D., D.J.C., A.E.E., F.E.M., D.S.F.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chase R.","family":"Brown","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Surgery (C.R.B.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9267-6531","authenticated-orcid":true,"given":"Lin","family":"Yang","sequence":"additional","affiliation":[{"name":"Center for Cardiovascular Outcomes, Quality, and Evaluative Research, University of Pennsylvania, Philadelphia (L.Y., P.W.G., D.S.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9475-410X","authenticated-orcid":true,"given":"Gustavo S.","family":"Guandalini","sequence":"additional","affiliation":[{"name":"Cardiovascular Division (T.M.M., G.S.G., M.C.H., J.S.A., P.S., R.D.S., G.E.S., R.D., S.N., S.D., D.J.C., A.E.E., F.E.M., D.S.F.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4050-6925","authenticated-orcid":true,"given":"Matthew C.","family":"Hyman","sequence":"additional","affiliation":[{"name":"Cardiovascular Division (T.M.M., G.S.G., M.C.H., J.S.A., P.S., R.D.S., G.E.S., R.D., S.N., S.D., D.J.C., A.E.E., F.E.M., D.S.F.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4928-3887","authenticated-orcid":true,"given":"Jeffrey S.","family":"Arkles","sequence":"additional","affiliation":[{"name":"Cardiovascular Division (T.M.M., G.S.G., M.C.H., J.S.A., P.S., R.D.S., G.E.S., R.D., S.N., S.D., D.J.C., A.E.E., F.E.M., D.S.F.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pasquale","family":"Santangeli","sequence":"additional","affiliation":[{"name":"Cardiovascular Division (T.M.M., G.S.G., M.C.H., J.S.A., P.S., R.D.S., G.E.S., R.D., S.N., S.D., D.J.C., A.E.E., F.E.M., D.S.F.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert D.","family":"Schaller","sequence":"additional","affiliation":[{"name":"Cardiovascular Division (T.M.M., G.S.G., M.C.H., J.S.A., P.S., R.D.S., G.E.S., R.D., S.N., S.D., D.J.C., A.E.E., F.E.M., D.S.F.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory E.","family":"Supple","sequence":"additional","affiliation":[{"name":"Cardiovascular Division (T.M.M., G.S.G., M.C.H., J.S.A., P.S., R.D.S., G.E.S., R.D., S.N., S.D., D.J.C., A.E.E., F.E.M., D.S.F.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajat","family":"Deo","sequence":"additional","affiliation":[{"name":"Cardiovascular Division (T.M.M., G.S.G., M.C.H., J.S.A., P.S., R.D.S., G.E.S., R.D., S.N., S.D., D.J.C., A.E.E., F.E.M., D.S.F.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia."},{"name":"Corporal Michael J. Crescenz VA Medical Center, Philadelphia (R.D., S.D., A.E.E., P.W.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8369-0259","authenticated-orcid":true,"given":"Saman","family":"Nazarian","sequence":"additional","affiliation":[{"name":"Cardiovascular Division (T.M.M., G.S.G., M.C.H., J.S.A., P.S., R.D.S., G.E.S., R.D., S.N., S.D., D.J.C., A.E.E., F.E.M., D.S.F.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4292-8061","authenticated-orcid":true,"given":"Sanjay","family":"Dixit","sequence":"additional","affiliation":[{"name":"Cardiovascular Division (T.M.M., G.S.G., M.C.H., J.S.A., P.S., R.D.S., G.E.S., R.D., S.N., S.D., D.J.C., A.E.E., F.E.M., D.S.F.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia."},{"name":"Corporal Michael J. Crescenz VA Medical Center, Philadelphia (R.D., S.D., A.E.E., P.W.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Callans","sequence":"additional","affiliation":[{"name":"Cardiovascular Division (T.M.M., G.S.G., M.C.H., J.S.A., P.S., R.D.S., G.E.S., R.D., S.N., S.D., D.J.C., A.E.E., F.E.M., D.S.F.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0433-8802","authenticated-orcid":true,"given":"Andrew E.","family":"Epstein","sequence":"additional","affiliation":[{"name":"Cardiovascular Division (T.M.M., G.S.G., M.C.H., J.S.A., P.S., R.D.S., G.E.S., R.D., S.N., S.D., D.J.C., A.E.E., F.E.M., D.S.F.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia."},{"name":"Corporal Michael J. Crescenz VA Medical Center, Philadelphia (R.D., S.D., A.E.E., P.W.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis E.","family":"Marchlinski","sequence":"additional","affiliation":[{"name":"Cardiovascular Division (T.M.M., G.S.G., M.C.H., J.S.A., P.S., R.D.S., G.E.S., R.D., S.N., S.D., D.J.C., A.E.E., F.E.M., D.S.F.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7374-4292","authenticated-orcid":true,"given":"Peter W.","family":"Groeneveld","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine (P.W.G.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia."},{"name":"Center for Cardiovascular Outcomes, Quality, and Evaluative Research, University of Pennsylvania, Philadelphia (L.Y., P.W.G., D.S.F.)."},{"name":"Corporal Michael J. Crescenz VA Medical Center, Philadelphia (R.D., S.D., A.E.E., P.W.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7374-4292","authenticated-orcid":true,"given":"David S.","family":"Frankel","sequence":"additional","affiliation":[{"name":"Cardiovascular Division (T.M.M., G.S.G., M.C.H., J.S.A., P.S., R.D.S., G.E.S., R.D., S.N., S.D., D.J.C., A.E.E., F.E.M., D.S.F.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia."},{"name":"Center for Cardiovascular Outcomes, Quality, and Evaluative Research, University of Pennsylvania, Philadelphia (L.Y., P.W.G., D.S.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40122-018-0097-6"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.0935"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6712a1"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm655051e1"},{"key":"e_1_3_3_6_2","unstructured":"Centers for Disease Control and Prevention. CDC WONDER. Accessed July 15 2021. wonder.cdc.gov"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1185\/03007995.2015.1005833"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.3109\/15360288.2012.751956"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/phar.1223"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/ejp.1337"},{"key":"e_1_3_3_11_2","first-page":"45","article-title":"Prescription opioid Prescribing in Western Europe and the United States.","volume":"103","author":"Meyer A","year":"2020","unstructured":"Meyer, A, LeClair, C, McDonald, JV. Prescription opioid Prescribing in Western Europe and the United States. R I Med J (2013). 2020;103:45\u201348.","journal-title":"R I Med J (2013)"},{"key":"e_1_3_3_12_2","first-page":"1","volume-title":"Narcotic drugs: estimated world requirements","author":"International Narcotics Control Board","year":"2016","unstructured":"International Narcotics Control Board. Narcotic drugs: estimated world requirements. United Nations: 2016;1\u2013472."},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2019.06.019"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2020.1445"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2015.12.008"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000002132"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1080\/14656566.2019.1583743"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2019.08.011"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0b013e318169d03b"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e3182a9a896"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e3181cf9281"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.4103\/joacp.JOACP_375_15"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2018.02.014"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2020.03.009"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2021.03.008"}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCULATIONAHA.121.055524","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T07:42:21Z","timestamp":1715586141000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCULATIONAHA.121.055524"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,16]]},"references-count":24,"journal-issue":{"issue":"20","published-print":{"date-parts":[[2021,11,16]]}},"alternative-id":["10.1161\/CIRCULATIONAHA.121.055524"],"URL":"https:\/\/doi.org\/10.1161\/circulationaha.121.055524","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,16]]},"assertion":[{"value":"2021-05-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-08-26","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-11-15","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}