| Anatomical mechanisms explaining damage to pacemaker leads, defibrillator leads, and failure of central venous catheters adjacent to the sternoclavicular joint. | |
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MedLine Citation:
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PMID: 7681196 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The literature suggests that approximately 93% of all pacemaker lead fractures occur in the segment of the lead lateral to the venous entry, and costoclavicular compression has been implicated. While blood vessels can be compressed by movements of the clavicle, our research suggests that lead and catheter damage in that region is caused by soft tissue entrapment rather than bony contact. Dissection of eight cadavers with ten leads revealed that two entered the cephalic vein, and were not included in the study. Of the other eight leads, four passed through the subclavius muscle, two through the costoclavicular ligament, and two through both these structures before entering the subclavian, internal jugular, or brachiocephalic vein. Anatomical studies demonstrated that entrapment by the subclavius muscle or the costoclavicular ligament could cause repeated flexing of leads during movements of the pectoral girdle. Cineradiology of patients with position dependent catheter occlusion confirmed entrapment by the subclavius muscle. Soft tissue entrapment imposes a static load upon leads and catheters, and repeated flexure about the point of entrapment may be responsible for damage previously attributed to cyclic costoclavicular compression. |
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Authors:
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J E Magney; D M Flynn; J A Parsons; D H Staplin; M V Chin-Purcell; S Milstein; D W Hunter |
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Publication Detail:
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Type: Comment; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Pacing and clinical electrophysiology : PACE Volume: 16 ISSN: 0147-8389 ISO Abbreviation: Pacing Clin Electrophysiol Publication Date: 1993 Mar |
Date Detail:
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Created Date: 1993-04-22 Completed Date: 1993-04-22 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 7803944 Medline TA: Pacing Clin Electrophysiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 445-57 Citation Subset: IM; S |
Affiliation:
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Department of Cell Biology and Neuroanatomy, University of Minnesota, Minneapolis 55455. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Arm
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physiology Bloodletting Cadaver Catheterization, Central Venous / instrumentation* Defibrillators, Implantable* Electrodes, Implanted* Equipment Failure Female Humans Male Movement / physiology Pacemaker, Artificial* Pressure Sternoclavicular Joint* Stress, Mechanical Subclavian Vein |
| Comments/Corrections | |
Comment On:
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Pacing Clin Electrophysiol. 1993 Mar;16(3 Pt 1):373-6
[PMID:
7681185
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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