Cardiac pathology of transvenous pacemakers

Huang, Tsau-Yuen; Baba, Nobuhisa

doi:10.1016/0002-8703(72)90037-3

Cited by 99 publications

(55 citation statements)

References 17 publications

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“…This prospective analysis confirms the hypothesis generated by Biefer et al, 14 demonstrating pocket scar severity to be a predictor of TLE difficulty after controlling for age, gender, number of leads extracted, implant duration, and indication for TLE. While the pathologic changes associated with endovascular leads have been described previously, [9][10][11] this is first description of pathologic changes within the device pocket. Furthermore, this study is the first to demonstrate an association between calcific changes in the pocket and TLE difficulty.…”

Section: Discussionmentioning

confidence: 83%

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Device Pocket Scar Predicts Transvenous Lead Extraction Difficulty

Maytin¹

2015

JICRM

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ABSTRACT. The challenges and risks of transvenous lead extraction (TLE) of cardiovascular implantable electronic devices (CIEDs) are principally related to the body's foreign body response to endovascular leads. Despite this understanding, predictors of severe endovascular scar formation have not been clearly identified. The aim was to evaluate if the severity of the pocket scar may help predict endovascular scar and TLE difficulty. We performed a prospective analysis of consecutive patients undergoing TLE. Patient and procedural characteristics, classification of pocket scar severity, operator assessment of TLE difficulty, extraction time, and number of extraction sheaths (ESs) used are reported. Logistic and linear regression analyses were utilized to test the adjusted association between pocket scar and the combined endpoint and subjective difficulty assessed by the operator, respectively. Between November 2010 and February 2012, 144 patients underwent TLE with assessment of pocket scar. The cohort was 63% male with mean age 62 ± 16 years. Average implant duration was 84 ± 53 months. Indications for TLE included infection 35%, malfunction 30%, upgrade 8%, and other 27%. Each incremental increase in pocket scar severity was associated with a twofold increase in TLE difficulty (OR 2.03; 95% CI 1.005-4.110). TLE difficulty endpoint correlated significantly with the operator's assessment of procedural difficulty (r ¼ 0.74, po0.001). Operator scoring of TLE difficulty (1-10) was highly correlated with severity of CIED pocket scar (p ¼ 0.001). The severity of the scar in the device pocket correlates with multiple ES use and long extraction times and operator quantification of extraction difficulty. CIED pocket scar may help predict TLE difficulty.

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Section: Discussionmentioning

confidence: 83%

“…[9][10][11] Robust fibrosis develops in areas of direct contact between the lead and the vasculature and endocardium. The most common adhesion sites include the venous entry site, the superior vena cava (SVC) and the electrode-myocardial interface, with multiple areas of scar tissue found in the majority of patients.…”

Section: Introductionmentioning

confidence: 99%

Device Pocket Scar Predicts Transvenous Lead Extraction Difficulty

Maytin¹

2015

JICRM

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“…Уже через 12 ч после импланта-ции происходит формирование фиброзной обо-лочки вокруг электрода, которая может повли-ять на функцию клапана, а в первые 4-5 сут наиболее высок риск образования на электроде тромба, способного стать причиной острой три-куспидальной недостаточности [28]. G. Lin et al обнаружили, что ведущими ме-ханизмами развития TР после имплантации ЭКС у 41 пациента было соударение (интерфе-ренция) створки с электродом в 39% случаев, ад-гезия со структурами клапана у 34% больных и перфорация створки у 17% наблюдаемых [8].…”

Section: Discussionunclassified

Right ventricular pacemaker lead as an independent risk factor in the development of tricuspid regurgitation in the early postoperative period? Single-center prospective study

Glumskov¹,

Дурманов²,

Bazilev³

2017

Ann aritmol

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“…Наличие самого элект-рода и фиброзные наложения на нем способст-вуют развитию изменений в тканях ТК в виде отека, тромбоза уже через 4-5 сут после имплан-тации ААУ. Повышается адгезивная способ-ность тканей клапана [26]. Образующиеся впо-следствии фиброзные изменения в створках ТК способствуют неполному их схлопыванию и по-явлению у пациента ТР.…”

Section: имплантация антиаритмических устройств является методом выбоunclassified

Tricuspid Valve Regurgitation After Antiarrhythmic Device Implantation

Кропоткин¹,

Ivanitskiy²

2017

Ann aritmol

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Cardiac pathology of transvenous pacemakers

Cited by 99 publications

References 17 publications

Device Pocket Scar Predicts Transvenous Lead Extraction Difficulty

Device Pocket Scar Predicts Transvenous Lead Extraction Difficulty

Right ventricular pacemaker lead as an independent risk factor in the development of tricuspid regurgitation in the early postoperative period? Single-center prospective study

Tricuspid Valve Regurgitation After Antiarrhythmic Device Implantation

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