Document Detail

Autopsy and clinical context in deceased patients with implanted pacemakers and defibrillators: intracardiac findings near their leads and electrodes.
MedLine Citation:
PMID:  19684037     Owner:  NLM     Status:  MEDLINE    
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.
Miroslav Novak; Petr Dvorak; Pavel Kamaryt; Bronislava Slana; Jolana Lipoldova
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Publication Detail:
Type:  Journal Article     Date:  2009-08-14
Journal Detail:
Title:  Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology     Volume:  11     ISSN:  1532-2092     ISO Abbreviation:  Europace     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-11-02     Completed Date:  2010-01-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883649     Medline TA:  Europace     Country:  England    
Other Details:
Languages:  eng     Pagination:  1510-6     Citation Subset:  IM    
St Ann University Hospital, Masaryk University, Pekarska 53, Brno 65691, Czech Republic.
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MeSH Terms
Autopsy / statistics & numerical data
Cardiac Pacing, Artificial / mortality*,  utilization
Czech Republic / epidemiology
Defibrillators, Implantable / utilization*
Electric Countershock / instrumentation,  mortality*,  utilization
Heart Injuries / mortality*
Pacemaker, Artificial / utilization*
Prosthesis Failure*
Thrombosis / mortality*
Wounds, Penetrating / mortality*
Comment In:
Europace. 2009 Nov;11(11):1419-20   [PMID:  19880407 ]

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