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Postpacemaker implant pericarditis: incidence and outcomes with active-fixation leads
Soori Sivakumaran1, Marleen E Irwin, Sajad S Gulamhusein
1Division of Cardiac Sciences, Grey Nuns Hospital, Edmonton, Alberta, Canada. mirwin@cha.ab.ca
Pacing and Clinical Electrophysiology : PACE
|June 7, 2002
Summary
Pacemaker implantation with active-fixation atrial leads significantly increases the risk of pericarditis, a serious complication. Patients receiving these leads require close monitoring for potential cardiac tamponade.
Area of Science:
- Cardiology
- Medical Devices
- Clinical Research
Background:
- Pericarditis is a recognized complication following pacemaker implantation.
- The specific risk associated with active-fixation atrial leads requires further evaluation.
Purpose of the Study:
- To assess the incidence and outcomes of pericarditis after pacemaker implantation.
- To compare the risk of pericarditis between active-fixation and passive-fixation atrial leads.
Main Methods:
- A retrospective review of 1,021 patients undergoing pacemaker implantation between 1991 and 1999.
- Comparison of pericarditis incidence in patients with active-fixation atrial leads versus those with passive-fixation or no atrial leads.
Main Results:
- Four out of 79 patients (5%) receiving active-fixation atrial leads developed pericarditis.
- No pericarditis cases were observed in 942 patients with passive-fixation or ventricular-only leads (P < 0.001).
- One patient died from cardiac tamponade, while others experienced symptom resolution with conservative treatment.
Conclusions:
- Active-fixation atrial leads are associated with a significantly higher risk of post-pacemaker implantation pericarditis.
- Lead perforation through the atrial wall may precipitate pericarditis.
- Close patient monitoring is crucial due to the risk of cardiac tamponade.