AIMS: To evaluate intracardiac findings near leads and causes of death in pacemaker/defibrillator patients. METHODS AND RESULTS: Special autopsy was performed on 78 patients deceased in a hospital. Age at death was 77.9 +/- 10.0, implantation-death interval 4.0 +/- 3.3 years, ventricular leads n = 78, and atrial leads n = 21. Thrombi along leads in brachiocephalic vein/upper caval vein (BV/UCV) were found in 22 (7), in right atrium (RA) in 11 (8), and in right ventricle (RV) in 11 cases. Bipolar lead rings were fixed by fibrous tissue in 43 (4) cases. Connective tissue bridges and tunnels were found in BV/UCV in 44 (13), in RA in 17 (15), and in RV in 68 cases, with a length of 0.2-12.0 cm. Right ventricular leads in tricuspidal orifice were fixed by fibrous tissue in 11 and penetrating chordae in 25 cases. Main causes of death were: heart failure in 35, pulmonary embolism in 9, and myocardial infarction in 11 cases. CONCLUSION: We have found (i) thrombi on ventricular/atrial leads in 33/48%, (ii) bipolar lead rings fixed by fibrous tissue in 68/22%, (iii) connective tissue bridges or tunnels in ventricle/atrium in 87/71%, and (iv) ventricular leads fixed to valve or penetrating chordae in 46% of patients. We do recommend caution when extracting leads.
AIMS: To evaluate intracardiac findings near leads and causes of death in pacemaker/defibrillator patients. METHODS AND RESULTS: Special autopsy was performed on 78 patients deceased in a hospital. Age at death was 77.9 +/- 10.0, implantation-death interval 4.0 +/- 3.3 years, ventricular leads n = 78, and atrial leads n = 21. Thrombi along leads in brachiocephalic vein/upper caval vein (BV/UCV) were found in 22 (7), in right atrium (RA) in 11 (8), and in right ventricle (RV) in 11 cases. Bipolar lead rings were fixed by fibrous tissue in 43 (4) cases. Connective tissue bridges and tunnels were found in BV/UCV in 44 (13), in RA in 17 (15), and in RV in 68 cases, with a length of 0.2-12.0 cm. Right ventricular leads in tricuspidal orifice were fixed by fibrous tissue in 11 and penetrating chordae in 25 cases. Main causes of death were: heart failure in 35, pulmonary embolism in 9, and myocardial infarction in 11 cases. CONCLUSION: We have found (i) thrombi on ventricular/atrial leads in 33/48%, (ii) bipolar lead rings fixed by fibrous tissue in 68/22%, (iii) connective tissue bridges or tunnels in ventricle/atrium in 87/71%, and (iv) ventricular leads fixed to valve or penetrating chordae in 46% of patients. We do recommend caution when extracting leads.
Authors: Charles J Lenz; Christopher V DeSimone; Shiva P Ponamgi; Alan Sugrue; Lawrence J Sinak; Krishnaswamy Chandrasekaran; Douglas L Packer; Samuel J Asirvatham Journal: J Interv Card Electrophysiol Date: 2016-02-22 Impact factor: 1.900
Authors: Vaibhav R Vaidya; Christopher V DeSimone; Samuel J Asirvatham; Vishnu M Chandra; Amit Noheria; David O Hodge; Joshua P Slusser; Alejandro A Rabinstein; Paul A Friedman Journal: J Interv Card Electrophysiol Date: 2014-04-27 Impact factor: 1.900
Authors: Amit Noheria; Shiva P Ponamgi; Christopher V Desimone; Vaibhav R Vaidya; Christopher A Aakre; Elisa Ebrille; Tiffany Hu; David O Hodge; Joshua P Slusser; Naser M Ammash; Charles J Bruce; Alejandro A Rabinstein; Paul A Friedman; Samuel J Asirvatham Journal: Europace Date: 2015-03-12 Impact factor: 5.214
Authors: Joseph Donnelly; James Gabriels; Andrew Galmer; Jonathan Willner; Stuart Beldner; Laurence M Epstein; Apoor Patel Journal: Curr Treat Options Cardiovasc Med Date: 2018-07-11
Authors: Jose Maria Frutos Perez; Marina Llopis Sanchis; Beatriz Moreno Torres; Andrea Esteve Villar Del Saz; Ana Ventura Esteve; Maria Angeles Martinez Pascual; Mariam Perea Ribis; Alba Camarena Molina; Leyre Jorquer Vidal; Gustavo Lobato Correia; Jose Manuel Querol Ribelles Journal: Eur J Case Rep Intern Med Date: 2021-03-08