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Published on: December 11, 2017
Subacute cardiac perforations associated with active fixation leads.
Maciej Sterliński1, Andrzej Przybylski, Aleksander Maciag
1Institute of Cardiology, Spartańska 1, 02-637 Warsaw, Poland.
Summary
Cardiac perforation risk from pacing and defibrillation leads is low. Active fixation leads show an increased risk, though no specific lead model was definitively linked to higher perforation rates.
Area of Science:
- Cardiology
- Medical Device Safety
Background:
- Recent reports suggest an increased rate of cardiac perforation with certain cardiac lead models.
- Understanding the relationship between lead models and cardiac perforation is crucial for patient safety.
Purpose of the Study:
- To assess the association between cardiac perforations and specific models of pacing and defibrillation leads.
- To investigate the risk factors contributing to cardiac perforations during lead implantation.
Main Methods:
- Retrospective analysis of 2247 pacing and defibrillation lead implantations between January 2007 and March 2008.
- Comparison of perforation rates between active and passive fixation leads, and between pacemaker and implantable cardioverter-defibrillator procedures.
Main Results:
- Eight cardiac perforations (0.5%) occurred in 1419 patients.
- All perforations were associated with active fixation leads (P < 0.01).
- No significant difference in perforation rates between pacemaker and implantable cardioverter-defibrillator implantations (P = 0.13).
Conclusions:
- The incidence of cardiac perforation related to cardiac leads is low.
- Active fixation leads are associated with a higher risk of cardiac perforation.
- No specific lead model demonstrated a statistically significant increased risk of perforation.
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01:28Esophageal Perforation-II: Clinical Manifestations and Management
Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
Clinical Manifestations:
01:22Esophageal Perforation-I: Introduction
Esophageal perforation is a severe medical condition characterized by a breach in the integrity of the esophageal wall. This breach can occur due to various factors such as trauma, medical procedures, or underlying diseases. When the esophageal wall is compromised, it allows food, fluids, and digestive juices into the chest cavity or adjacent structures, leading to potential complications and health risks.
The location of esophageal perforation can vary, occurring anywhere along the esophagus.
The location of esophageal perforation can vary, occurring anywhere along the esophagus.