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Europace Advance Access originally published online on December 24, 2008
Europace 2009 11(2):206-212; doi:10.1093/europace/eun363
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

Leads and Lead Extraction

Subacute cardiac perforations associated with active fixation leads

Maciej Sterlinski, Andrzej Przybylski*, Aleksander Maciag, Pawel Syska, Mariusz Pytkowski, Michal Lewandowski, Ilona Kowalik, Bohdan Firek, Piotr Kolsut, Grzegorz Religa, Mariusz Kusmierczyk, Franciszek Walczak and Hanna Szwed

Institute of Cardiology, Spartanska 1, 02-637 Warsaw, Poland

Aims: Having several recently published reports on increased rate of cardiac perforation with some lead models as background, we assess the relation between cardiac perforations and models of leads used.

Methods and results: All pacing and defibrillation leads implantations between 1 January 2007 and 31 March 2008 were analysed retrospectively. There were 2247 leads implanted in 1419 patients aged 67.6 ± 14.1, 1200 (53%) active and 1047 (47%) passive fixation leads. Cardiac perforation occurred in eight patients (0.5%). The number of perforations does not differ significantly between the pacemaker and implantable cardioverter defibrillator implantations (five and three cases, respectively, P = 0.13). All perforations were associated with the active fixation leads implantation (8 vs. 0, P < 0.01). Only four models of leads were associated with perforations, but the risk of their use was not statistically significantly increased, when compared with other active fixation leads placed in the adequate position.

Conclusions: The incidence of cardiac perforation related to pacing and defibrillation leads is low. The use of active fixation leads is associated with an increased risk of cardiac perforation. We did not find any correlation between the perforation rate and any particular model of the implanted lead.

Key Words: Cardiac perforation, Transvenous leads, Pacemaker, Implantable cardioverter-defibrillator, Complications

* Corresponding author. Tel: +48 223434050, Fax: +48 228449510, Email: aprzybylski{at}ikard.pl or aprzybylski{at}adres.pl

Manuscript submitted 17 June 2008. Accepted after revision 2 December 2008.


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