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Sterile Pericarditis in Aachener Minipigs As a Model for Atrial Myopathy and Atrial Fibrillation
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Incidence and predictors of cardiac perforation after permanent pacemaker placement

Srijoy Mahapatra1, Kevin A Bybee, T Jared Bunch

  • 1Division of Cardiology, Mayo Clinic, Rochester, Minnesota 55902, USA.

Heart Rhythm
|September 21, 2005
PubMed

Insights

Pericardial effusion after pacemaker implantation is rare. Avoiding temporary pacemakers and careful steroid use can minimize risks of this cardiac perforation complication.

Area of Science:

  • Cardiology
  • Cardiac Electrophysiology
  • Medical Device Complications

Background:

  • Pericardial effusion can indicate cardiac perforation following permanent pacemaker (PPM) implantation.
  • Risk factors for developing post-PPM effusion remain unevaluated.

Purpose of the Study:

  • To identify predictors of symptomatic pericardial effusion after PPM placement.
  • To evaluate risk factors associated with post-pacemaker cardiac perforation.

Main Methods:

  • Cross-referencing Mayo Clinic pacemaker and echocardiogram databases (1995-2003).
  • Analyzing 4,280 PPM implantations, identifying 50 (1.2%) patients with significant effusion.
  • Matching affected patients with 100 controls without effusion.

Main Results:

  • Concomitant temporary transvenous pacemaker use (HR 2.7) and pre-implant steroid use (HR 3.2) were significant multivariate predictors of effusion.
  • Helical screw leads (HR 2.5) also increased risk, while higher right ventricular systolic pressure (>35 mmHg) was protective (HR 0.70).
  • Lower BMI (<20), older age, and longer fluoroscopy times were weaker predictors.

Conclusions:

  • The incidence of post-implant pericardial effusion is low.
  • Minimizing effusion risk involves avoiding unnecessary temporary pacemaker placement.
  • Caution is advised with steroid use in patients undergoing permanent pacemaker implantation.
Abstract

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