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Outcomes of Lead Revision for Myocardial Perforation After Cardiac Implantable Electronic Device Placement.
- Source :
- Journal of Cardiovascular Electrophysiology; Oct2014, Vol. 25 Issue 10, p1119-1124, 6p, 3 Black and White Photographs, 2 Charts
- Publication Year :
- 2014
-
Abstract
- Percutaneous Lead Revision for Cardiac Perforation Introduction Cardiac perforation is an infrequent but potentially life-threatening complication associated with placement of a cardiac implantable electronic device (CIED). The objective of this study was to determine the outcomes of percutaneous lead revision in patients who had lead perforation of the myocardium after CIED placement. Methods and Results We reviewed records of 1,458 patients who underwent CIED lead extraction or repositioning. Of these, 31 (2.1%) had the procedure performed for lead perforation as a complication of CIED placement. Demographic, clinical, and follow-up characteristics of the patients were analyzed. Mean (SD) patient age was 65 (23) years. Cardiac perforation was detected within 24 hours after implantation in 9 patients, within 1 month in 17, and greater than 1 month in 5. Pericardiocentesis was performed with a pigtail drainage catheter in place before the lead revision in 17 patients (55%) who had pericardial effusion, with or without hemodynamic compromise. All culprit leads were successfully managed with percutaneous lead removal (n = 3 [10%]), new lead placement (n = 12 [38%]), or lead repositioning (n = 16 [52%]). Of the 17 patients with pericardiocentesis before the reoperation, none had tamponade develop; in contrast, 3 of the remaining 14 patients had tamponade develop and required urgent pericardiocentesis. All patients survived without requiring open chest surgery. Conclusion Percutaneous removal or repositioning of the perforating lead is feasible and appears effective. Placement of a prophylactic pericardial drain catheter may reduce the incidence of urgent pericardiocentesis during or after a procedure. [ABSTRACT FROM AUTHOR]
- Subjects :
- MEDICAL drainage
MYOCARDIUM
ELECTRODES
FISHER exact test
IMPLANTABLE cardioverter-defibrillators
ARTIFICIAL implants
HEALTH outcome assessment
PERICARDIUM paracentesis
STATISTICS
T-test (Statistics)
DATA analysis
TREATMENT effectiveness
MEDICAL device removal
DESCRIPTIVE statistics
WOUNDS & injuries
Subjects
Details
- Language :
- English
- ISSN :
- 10453873
- Volume :
- 25
- Issue :
- 10
- Database :
- Complementary Index
- Journal :
- Journal of Cardiovascular Electrophysiology
- Publication Type :
- Academic Journal
- Accession number :
- 98837211
- Full Text :
- https://doi.org/10.1111/jce.12457