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Histological findings around electrodes in pacemaker and implantable cardioverter-defibrillator patients: comparison of steroid-eluting and non-steroid-eluting electrodes
P. Dvorak, M. Novak, P. Kamaryt, B. Slana, J. Lipoldova, P. Dvorak,
Language English Country England, Great Britain
Document type Comparative Study, Journal Article, Research Support, Non-U.S. Gov't
NLK
Free Medical Journals
from 1999 to 1 year ago
PubMed Central
from 2008
Open Access Digital Library
from 1999-01-01
Medline Complete (EBSCOhost)
from 1999-01-01
Oxford Journals Open Access Collection
from 1999-01-01
- MeSH
- Pigments, Biological analysis MeSH
- Defibrillators, Implantable adverse effects MeSH
- Endocardium cytology MeSH
- Fibrin analysis MeSH
- Adrenal Cortex Hormones administration & dosage MeSH
- Pacemaker, Artificial adverse effects MeSH
- Coronary Sinus pathology MeSH
- Middle Aged MeSH
- Humans MeSH
- Myocardium cytology MeSH
- Giant Cells cytology MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Thrombosis pathology MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Comparative Study MeSH
AIMS: To analyse histological findings surrounding the electrodes in pacemaker/implantable cardioverter-defibrillator (PM/ICD) patients. To compare histology around steroid-eluting and non-steroid ventricular pacing electrodes. METHODS AND RESULTS: In autopsied PM/ICD patients histopathological findings around the electrodes were determined. Seventy patients were studied, PM(58), ICD(12), mean age 75.1 ± 9.3 years. The implantation-death interval was 4.0 ± 3.3 years. Most causes of death were cardiac (PM 52%, ICD 58%). The majority of atrial electrodes were attached to the endocardium and most ventricular electrodes were found in the myocardium (P ≤ 0.001). The maximum thickness of the fibrous electrode sheath was greatest for the ICD ventricular electrodes. Some electrodes were covered with fibrin thrombi and granulation tissue, most frequently in the ICD ventricular electrodes. The fibrous sheath usually contained chronic inflammatory cells and in some cases particles of foreign material, foreign body giant cells, and haematogenous pigment. The tissue around steroid-eluting ventricle PM electrodes was compared with the tissue around the non-steroid-eluting ventricle PM electrodes; granulation tissue, foreign material, giant cells being found more frequently around the steroid-eluting electrodes. The fibrous sheath was slightly thinner in the steroid-eluting electrodes. The histology around four coronary sinus electrodes was described. CONCLUSIONS: Atrial electrodes were attached more superficially to the endocardium while PM and ICD ventricular electrodes were more frequently embedded in the myocardium. The electrodes were covered by a connective tissue sheath as a result of thrombus organization. This process persisted most frequently around ICD ventricular electrodes. Only borderline differences were found between the histological findings around steroid-eluting and non-steroid-eluting PM ventricular electrodes.
References provided by Crossref.org
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- $a AIMS: To analyse histological findings surrounding the electrodes in pacemaker/implantable cardioverter-defibrillator (PM/ICD) patients. To compare histology around steroid-eluting and non-steroid ventricular pacing electrodes. METHODS AND RESULTS: In autopsied PM/ICD patients histopathological findings around the electrodes were determined. Seventy patients were studied, PM(58), ICD(12), mean age 75.1 ± 9.3 years. The implantation-death interval was 4.0 ± 3.3 years. Most causes of death were cardiac (PM 52%, ICD 58%). The majority of atrial electrodes were attached to the endocardium and most ventricular electrodes were found in the myocardium (P ≤ 0.001). The maximum thickness of the fibrous electrode sheath was greatest for the ICD ventricular electrodes. Some electrodes were covered with fibrin thrombi and granulation tissue, most frequently in the ICD ventricular electrodes. The fibrous sheath usually contained chronic inflammatory cells and in some cases particles of foreign material, foreign body giant cells, and haematogenous pigment. The tissue around steroid-eluting ventricle PM electrodes was compared with the tissue around the non-steroid-eluting ventricle PM electrodes; granulation tissue, foreign material, giant cells being found more frequently around the steroid-eluting electrodes. The fibrous sheath was slightly thinner in the steroid-eluting electrodes. The histology around four coronary sinus electrodes was described. CONCLUSIONS: Atrial electrodes were attached more superficially to the endocardium while PM and ICD ventricular electrodes were more frequently embedded in the myocardium. The electrodes were covered by a connective tissue sheath as a result of thrombus organization. This process persisted most frequently around ICD ventricular electrodes. Only borderline differences were found between the histological findings around steroid-eluting and non-steroid-eluting PM ventricular electrodes.
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