Autopsy and clinical context in deceased patients with implanted pacemakers and defibrillators: intracardiac findings near their leads and electrodes
Jazyk angličtina Země Velká Británie, Anglie Médium print-electronic
Typ dokumentu časopisecké články
PubMed
19684037
DOI
10.1093/europace/eup216
PII: eup216
Knihovny.cz E-zdroje
- MeSH
- defibrilátory implantabilní statistika a číselné údaje MeSH
- elektrická defibrilace přístrojové vybavení mortalita statistika a číselné údaje MeSH
- kardiostimulace umělá mortalita statistika a číselné údaje MeSH
- kardiostimulátor statistika a číselné údaje MeSH
- komorbidita MeSH
- lidé MeSH
- penetrující rány mortalita MeSH
- pitva statistika a číselné údaje MeSH
- poranění srdce mortalita MeSH
- selhání protézy * MeSH
- senioři MeSH
- trombóza mortalita MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika epidemiologie MeSH
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.
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