Predictors of the right ventricular perforation caused by active-fixation pacing and defibrillator leads: A single-centre experience

Celikyurt U., Acar B., Yavuz Ş., Agacdiken A., Vural A.

JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, vol.35, no.3, pp.399-405, 2024 (SCI-Expanded, Scopus) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 35 Issue: 3
  • Publication Date: 2024
  • Doi Number: 10.1111/jce.16181
  • Journal Name: JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, CINAHL, MEDLINE
  • Page Numbers: pp.399-405
  • Keywords: active-fixation lead, cardiac perforation, slack height, slack score, slack width
  • Kocaeli University Affiliated: Yes

Abstract

IntroductionActive-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.MethodsWe 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.ResultsUnivariate 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.ConclusionFluoroscopic 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.