Incidence and predictors of clinically relevant cardiac perforation associated with systematic implantation of active-fixation pacing and defibrillation leads: a single-centre experience with over 3800 implanted leads

Fecha de publicación: 01/01/2017

Autores de IIS La Fe

Óscar Cano Pérez

Autor
Ana Andrés Lahuerta

Autor
Pau Alonso Fernández

Autor
Joaquín Osca Asensi

Autor
María José Sancho-Tello De Carranza

Autor
Jose Olague De Ros

Autor
Luis Vicente Martínez Dolz

Autor

Grupos

Grupo de Investigación Clínica y Traslacional en Cardiología

Investigador Principal

Esther Roselló Lletí
Regeneración y Trasplante Cardíaco

Leader

Pilar Sepúlveda Sanchis

Abstract

Aims Active-fixation leads have been associated with higher incidence of cardiac perforation. Large series specifically evaluating this complication are lacking. We sought to evaluate the incidence and predictors of clinically relevant cardiac perforation in a consecutive series of patients implanted with active-fixation pacing and defibrillation leads. Methods and results We conducted a retrospective observational study including all consecutive patients implanted with an active-fixation pacing/defibrillation lead at our institution from July 2008 to July 2015. The incidence of clinically relevant cardiac perforation and cardiac tamponade was evaluated. Univariate and multivariate analyses were used to identify predictors of cardiac perforation. Acute and long-term management of these patients was also investigated. A total of 3822 active-fixation pacing (n = 3035) and defibrillation (n = 787) leads were implanted in 2200 patients. Seventeen patients (0.8%) had clinically relevant cardiac perforation (13 acute and 4 subacute perforations), and 13 (0.5%) had cardiac tamponade resolved with pericardiocentesis. None of the patients with cardiac perforation required surgical treatment. In multivariate analysis, an age >80 years (OR 3.84, 95% CI 1.14-12.87, P = 0.029), female sex (OR 3.14, 95% CI 1.07-9.22, P = 0.037), and an apical position of the right ventricular lead (OR 3.37, 95% CI 1.17-9.67, P = 0.024) were independent predictors of cardiac perforation. Conclusions Implantation of active-fixation leads is associated with a low incidence of clinically relevant cardiac perforation. Older and female patients have a higher risk of perforation as well as those patients receiving the ventricular lead in an apical position.

Datos de la publicación

ISSN/ISSNe:: 1099-5129, 1532-2092
Tipo:: Article
Páginas:: 96-102
DOI:: 10.1093/europace/euv410
Factor de Impacto:: 2,748 SCImago ℠
Cuartil:: Q1 SCImago ℠

Documentos

No hay documentos

Métricas

Filiaciones

Cano, O:: Electrophysiology Section, Cardiology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain

Hosp Univ & Politecn La Fe, Dept Cardiol, Electrophysiol Sect, Valencia, Spain
Andres, A:: Instituto de Investigación. Instituto Investigación Sanitaria La Fe, Valencia, Spain

Hosp Univ & Politecn La Fe, Dept Cardiol, Electrophysiol Sect, Valencia, Spain

Instituto de Investigación. Inst Invest Sanitaria La Fe, Valencia, Spain
Alonso, P:: Instituto de Investigación. Instituto Investigación Sanitaria La Fe, Valencia, Spain

Hosp Univ & Politecn La Fe, Dept Cardiol, Electrophysiol Sect, Valencia, Spain

Instituto de Investigación. Inst Invest Sanitaria La Fe, Valencia, Spain
Osca, J:: Hosp Univ & Politecn La Fe, Dept Cardiol, Electrophysiol Sect, Valencia, Spain
Sancho-Tello, MJ:: Hosp Univ & Politecn La Fe, Dept Cardiol, Electrophysiol Sect, Valencia, Spain
Olague, J:: Hosp Univ & Politecn La Fe, Dept Cardiol, Electrophysiol Sect, Valencia, Spain
Martinez-Dolz, L:: Hosp Univ & Politecn La Fe, Dept Cardiol, Electrophysiol Sect, Valencia, Spain