학술논문
Predictors of the right ventricular perforation caused by active‐fixation pacing and defibrillator leads: A single‐centre experience.
Document Type
Article
Source
Subject
*RISK assessment
*HEART injuries
*SCIENTIFIC observation
*TERTIARY care
*RETROSPECTIVE studies
*DESCRIPTIVE statistics
*MULTIVARIATE analysis
*ODDS ratio
*IMPLANTABLE cardioverter-defibrillators
*MEDICAL records
*ACQUISITION of data
*STATISTICS
*CARDIAC pacemakers
*RIGHT heart ventricle
*COMPARATIVE studies
*CONFIDENCE intervals
*FLUOROSCOPY
*DISEASE risk factors
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Language
ISSN
1045-3873
Abstract
Introduction: Active‐fixation leads have been associated with higher incidence of cardiac perforation. Large series specifically evaluating radiographic predictors of right ventricular (RV) lead perforation are lacking. Methods: We conducted a retrospective observational study including 1691 consecutive patients implanted with an active fixation pacing and defibrillator lead at our institution between January 2015 and January 2021. Fourteen patients who had clinically relevant RV perforation caused by pacemaker and implantable cardioverter‐defibrillator leads were included in the study. Results: Univariate and multivariate analyses were used to identify predictors of RV perforation. In multivariate analysis, lead slack score (odds ratio [OR]: 3.694, 95% confidence interval [CI]: 1.066–12.807; p =.039), change in lead slack height (OR: 1.218, 95% CI: 1.011–1.467; p =.038) and width (OR: 1.253, 95% CI: 1.120–1.402; p =.001), left ventricular ejection fraction (OR: 0.995, 95% CI: 0.910–1.088; p =.032) were independent predictors of RV perforation. Conclusion: Fluoroscopic predictors of RV perforation associated with RV lead can be easily determined during implantation. Identification of these predictors may prevent the sequelae of RV perforation associated with active‐fixation leads. [ABSTRACT FROM AUTHOR]